Hepatic veins as the only hepatic drainage veins are the important functional part of liver anatomy in the field of surgery.With the development of imaging technology,especially the application of three-dimensional visualization technology,it can provide precise and comprehensive information in the study of hepatic veins.And thus this paper comprehensively reviewed the recent researches on the three dimensional visualization technology for observign the hepatic veins.

nses (P<0.01).Standardized management is favorable in community management of patients with coronary heart disease.

Objective To investigate the clinical effect of high dose of calcitriol on end-stage renal disease (ESRD) in patients with secondary hyperparathyroidism (SHPT). Methods The clinical data of patients with ESRDcomplicated with SHPT were retrospectively analyzed. According to the treatment method were divided into control group and observation group, the control group were given conventional dose of calcitriol treatment, the observation group were treated with high dose of calcitriol. The differences of calcium and phosphorus levels, parathyroid hormone (PTH) level and quality of life were observed between the two groups before and after treatment. Results The serum phosphorus, calcium and calcium-phosphorus product in two groups of patients before treatment had no significant difference. After treatment, the above indicators decreased in two groups of patients compared with those before treatment, and the observation group was significantly lower (P<0.05). Before treatment, there was no difference in the levels of PTH between the two groups. After treatment, the level of PTH in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). There was no significant difference in quality of life between the two groups before treatment. After treatment, the quality of life in the two groups were higher than before treatment, and the observation group was significantly higher (P<0.05). Conclusion High dose of calcitriol has good therapeutic effect for ESRD patients with SHPT and can significantly improve the patient's calcium and phosphorus and PTH levels, improve the quality of life of patients.

OBJECTIVETo evaluate the effect of repeated sintering on the color and translucency of dental lithium disilicate-based glass ceramic.

METHODSThirty disc specimens (10 mm in diameter, and 1.00 mm ± 0.01 mm in thickness) were fabricated using an IPS e.max Press HT A2 ingot and then randomly divided into six groups (SO, S1, S2, S3, S4, and S5) (n = 5). Each group was sintered 0, 1, 2, 3, 4, and 5 times individually according to the manufacturer's recommendation. After polishing, ultrasonic cleaning, and drying, the color parameters (L*, a*, and b* values) and transmittance (τ) of all the specimens were measured using a ShadeEye NCC dental colorimeter and a TM-2 spectrophotometer, respectively. Subsequently, C*ab and ΔE were calculated. The results were statistically analyzed using SPSS 17.0 software for ANOVA and LSD.

RESULTSAfter repeated sintering, the L* value significantly decreased (P < 0.05), and the a*, b*, and C*ab values initially increased and then decreased (P < 0.05). The color parameters (L*, a*, and b*) and the C*ab values of group S3 were higher than those of the other groups. The τ values initially increased and then decreased (P < 0.05), and these values were optimal when sintered twice. In terms of transmittance (τ), statistical differences existed between the following groups: S0 and S2, S0 and S3,.S2 and S5, and S3 and S5 (P < 0.05). Compared with group S0, the color differences ΔE were 0.89 minimally and 2.01 maximally after different sintering times, which can be clinically acceptable.

CONCLUSIONRepeated sintering can affect the color and translucency of the IPS e.max Press lithium disilicate-based glass ceramic, but the color difference can be clinically acceptable.

ObjectiveTo collect and analyze patients' evaluation of basic medical services in Tianjin community health service institutions and to suggest improvements.MethodsA total of 15 community health service centers and 15 community health service stations in six urban districts of Tianjin were selected by stratified sampling and 300 randomly intercepted patients were surveyed by questionnaire.ResultsApproximately half ( 157/300, 52. 3％ ) the patients selected community health service institution as their first choice to seek medical attention. The most important reason for this, with 89.2％ patients responding yes, was that the community health service institution was close to home and very convenient.One quarter (79/300, 25.3％ ) of the patients regularly consulted the same doctor and 17.7％ (53/300)seldom went to see a doctor. The proportion of patients expressing a high degree of satisfaction to service standards and health professionals was 78. 7％, of which satisfaction with physicians' explanation about the patients' illness ranked highest at 83. 7％ (251/300). Patients' confidence level of doctors' diagnosis,physical examination, and auxiliary examination was 92. 0％. Moreover, most (87. 0％ ) patients reported that doctors communicate well with them; 85.0％ (255/300) patients received health instruction from doctors during visits, and 82. 0％ patients reported that doctors pay attention to protecting patients' privacy.The overall satisfaction of patients to environmental facilities and process management of community health service institutions was 73.6％. On the other hand, patient satisfaction with medicine types, service price,instrumentation and equipment, and environment were all lower than the average satisfaction. Conclusions Patients were basically satisfied with medical service in community health service institutions. Three main problem areas were identified: patients' use of community health services is deficient, medical service ability is partially lacking, and the service feature of general practitioners (GPs) is not obvious. Improvements of basic medical service ability in the community, cultivation of GPs, and basic medicine regulation are advocated.

Objective To study the effects of a cirrhotic environment on the metastasis of liver cancer in mice.Methods Male BALB/c mice were randomly assigned to two groups:cirrhosis group and control group.The cirrhosis group was treated by an injection of carbon tetrachloride intraperitoneally.H22 liver cancer cells were directly implanted under the capsule of each group after cirrhosis was established.The animals were sacrificed at 1,2,and 3 weeks after the operation.The metastatic behavior of the cancer cells was observed by the naked eye and microscopically.Additionally,the adhesion ability of the liver was assessed by measuring the expression of vascular cell adhesion molecule 1 (VCAM-1),E-selectin,and E-cadherin.Results After the operation,the cirrhosis group showed an obvious metastatic tendency in both intrahepatic (14/19) and extrahepatic ways (4/19),compared with the control group's intrahepatic (5/17) and extrahepatic ways (1/17) (P＜0.05).Immunohistochemisty for VCAM-1 and E-selectin showed a significant increase in the cirrhosis (P＜0.05).However,there was no difference observed in the E-cadherin between the cirrhosis and control group.Conclusion A cirrhotic liver environment may promote the metastasis of liver cancer cells by increasing the ability of liver adhesion.

Objective To investigate the effect of infiltrated mast cells on the biological characteristics of uterine carcinoma.Methods Twelve leiomyomas,ten uncertain malignant uterine leiomyomas,and seven uterine leiomyosarcomas were studied with light microscopy for the morphometry about their histological feature,mast cell particle and factor Ⅷ-related antigen(FⅧRAg);Cell apoptosis was measured by flow cytometry.The correlative analysis was carried out between the mast cell and others factors.Results Comparing with smooth muscle tumors of uncertain malignant potential(4209.9?273.0),the count of tumor cell was the highest in leiomyosarcoma(3557.6?346.3)(P

OBJECTIVE To detect ESBLs genes in 5 Shigella sonnei isolates.METHODS Susceptibility test to common antibiotics was performed through disk diffusion test,and ESBLs were confirmed according to CLSI.Conjugation experiment was performed to determine whether the resistance was transferable.The ESBLs gene was detected by PCR using universal primers for TEM,SHV,CTX-M,and the PCR products were also directly sequenced and analyzed.At the same time,the five isolates were analyzed by PFGE. RESULTS The five S.sonnei isolates were ESBLs producers and produced CTX-M-15 ESBLs,which were resistant to the most of the ?-lactams such as aztreonam,the first and second generation cephalosporins,cefotaxime,and non ?-lactam such as gentamicin,SF,but susceptible to ceftazidime,the 4th generation cephalosporins,Amikacin and meropenem.These strains were also intermediate to quinolones.CTX-M-15 gene could be transferred through conjugation.PFGE patterns of one isolate were different from the others.CONCLUSIONS Five S.sonnei isolates producing CTX-M-15 ESBLs are resistant to the most antibiotics.Clone spread is evident in these isolates.We should pay more attention to monitor these strains.

Objective To explore the causes of ambiguous genitalia.Methods Clinical data of 106 cases with ambiguous genitalia from Ruijin Hospital of Shanghai Jiaotong University School of Medicine were retrospectively analyzed.DNA fragments of related genes from parts of patients were amplified by means of polymerase chain reaction (PCR) and were directly sequenced to detect gene mutations.Results (1)The 106 ambiguous genitalia patients presented a variety of clinical phenotypes.Karyotype of 42 cases(39.6％)were 46,XX,while 62 cases(58.5％)were 46,XY and 2 cases(1.9％)were abnormal.(2)Forty(95.2％)patients with 46,XX were diagnosed with congenital adrenal hyperplasia(CAH) ;one case(2.4％) was adrenal cortical tumor and one case (2.4％) was 46,XX [sex determining region of Y choromosome (SRY) positive] male syndrome.(3) Fifty-three cases (85.5 ％) out of 46,XY karyotype were directly sequenced with steroid-5-alpha-reductase,alpha polypeptide 2 gene (SRD5A2),androgen receptor gene (AR) and steroidogenic factor-1 gene(SF-1).Sequencing analysis of SRD5A2 revealed 8 patients with compound heterozygous or homozygous mutations.A patient carried a novel missense mutation of SF-1 and another patient had a mutation of AR.(4) One abnormal karyotype was 46,XX/46,XY and the other was 46,XX/46,XY/46,X.+ may.ish (DYZ3 +) (DXZ1-).Conclusions (1) CAH is the most common cause of genital ambiguity in 46,XX patients but some rare causes such as adrenal cortical tumors or SRY positive should not be ignored.(2) To find the causes of 46,XY genital ambiguity,direct DNA sequencing analysis of candidate genes would be the better choice because of the complicate pathogenesis.(3)Abnormal karyotype also can lead to ambiguous genitalia.

Objective To construct a recombinant eukaryotic expression plasmid of glycosylphosphatidyl inositol(GPI)-anchored bcr/abl and explore its expression at mRNA and protein level.Methods The gene fragment encoding bcr/abl was amplified by PCR using the plasmid containing the cDNA sequence of P210 as template and then inserted into a eukaryotic expression vector pBudCE4.1.The constructed recombinant plasmid pBudCE4.1-bcr/abl was identified by restriction analysis and DNA sequencing.Lymphocytes were isolated from human peripheral blood and their total RNA was extracted.The gene fragment encoding GPI was amplified by RT-PCR using the obtained RNA as template and was inserted into the constructed recombinant plasmid pBudCE4.1-bcr/abl in order to anchor GPI and bcr/abl.The constructed recombinant plasmid pBudCE4.1-bcr/abl-GPI was transfected into COS-7 cells,and the expressions of objective fragment were detected by RT-PCR and Western blotting.Results The results of restriction analysis,PCR and DNA sequencing proved that GPI-anchored bcr/abl fusion fragment was correctly inserted into vector pBudCE4.1.The expression of bcr/abl fusion gene and fusion protein were identified in transfected COS-7 cells and on their membrane.Conclusion The recombinant plasmid pBudCE4.1-bcr/abl-GPI was successfully constructed and expressed on the membrane of COS-7 cells,which found a basis of cell immunity with GPI-anchored bcr/abl fusion gene.