Objective To introduce the imaging modalities used for the evaluation of postoperative complications of orthotopic liver transplantation (OLT) and to present the imaging findings of these complications. Methods The literatures related to the imaging methods and imaging manifestations of OLT complications were reviewed. Results Ultrasound was the initial imaging technique used for the detection of complications in the early postoperative period. Spiral CT and MRI yielded more accurate and comprehensive evaluation of postoperative complications in later stage. So far, there had been no specific imaging findings to suggest rejection reaction. The spectrum of imaging manifestations of OLT complications, such as vascular complications, biliary complications, liver parenchymal complications, and so on, were summarized and illustrated.Conclusion Imaging examination (especially ultrasound, spiral CT and MRI ) plays an important role in the evaluation of postoperative complications of OLT.

Objective To investigate the effect of propofol anesthesia on hemodynamic changes and dose requirement of sodium nitroprusside (SNP) during SNP-induced hypotension.Methods Sixteen patients undergoing elective microneurosurgery were randomly assigned to one of two groups: propofol group and isoflurane group. In propofol group (n=8) anesthesia was maintained with propofol (infusion rate 100?g?kg -1?min -1 ) after dural opening, whereas in isoflurane group (n=8) anesthesia was maintained with 1.3 MAC isoflurane.After 20 min the MAP of both groups was reduced by 40% with continuous infusion of 0.01% SNP solution.Results Blood pressure was more easily reduced and maintained in propofol group, and was lower in propofol group than that in isoflurane group following SNP withdrawl (P

Objective To evaluate the effect of Danshen Chuanxiongqin injection combined with Xuesaitong capsule on blood viscosity in patients with pulmonary heart disease.Methods 80 patients with pulmonary heart disease who were admitted to our hospital between January 2013 and November 2015 were studied,the patients were randomly divided into the combined group and the control group according to the order of admission,40 cases in each group.Control groups were treated with Xuesaitong capsule,and the combined group were treated with Danshen Chuanxiongqin injection on the basis of the control group.The clinical efficacy,blood viscosity(whole blood viscosity,plasma viscosity,whole blood viscosity ratio),blood indexes(blood platelet aggregation rate,erythrocyte aggregation index,erythrocyte deformation index),cardiac function and safety were observed.Results There were no significant differences in blood rheological indexes,LVEF,MAP and HR between the two groups before treatment.After treatment,the whole blood viscosity,plasma viscosity,whole blood viscosity ratio,platelet aggregation rate,erythrocyte aggregation index,erythrocyte deformation index,MAP and HR in the two groups were significantly lower than those before treatment,while LVEF was significantly higher,and the changes in the combined group were more significant than those in the control group(P<0.05).After treatment,the clinical total effective rate of treatment in the combined group(88.89％)was significantly higher than that in the control group(62.50％).Conclusion Danshen Chuanxiongqin injection combined with Xuesaitong capsule is effective in the treatment of pulmonary heart disease.It can significantly reduce blood viscosity,blood related indexes and improve cardiac function.

Objective To investigate the imaging features of malignant invasion of major intrahepatic ductal structures (the portal and hepatic venous vasculature, the bilie duct) by primary hepatocellular carcinoma (HCC) using multi-detector-row spiral CT (MDCT). Methods We retrospectively analyzed 68 documented HCC patients with tumorous invasion of the major intrahepatic ductal structures who had undergone contrast-enhanced dual-phase MDCT scanning of the upper abdomen.The morphological changes of the portal and hepatic venous vasculature, the bile duct, and the liver parenchyma at both the hepatic arterial phase and portal venous phase images were carefully observed and recorded. Results Among the 68 patients, 47 patients had malignant invasion of the intrahepatic portal venous vessels with secondary tumor thrombus formation; 12 patients had tumor involvement of the hepatic veins and intraheptic segment of the inferior vena cava; Tumor invasion of the bile duct was seen in 9 patents. The direct CT signs of tumor invasion of intrahepatic venous vessels included: ①dilatation or enlargement of the involved vein with intraluminal soft-tissue “filling defect”; ②enhancement of the tumor thrombus at hepatic arterial phase, the so-called “venous arterialization” phenomenon. The indirect CT signs included: ①arterial-venous shunt, ②early and heterogeneous enhancement of the hepatic parenchyma adjacent to HCC focus, ③cavernous transformation of the portal vein. The CT signs suggesting tumor invasion of the bile duct included: ①dilation of the bile ducts near or proximal to HCC lesion, ②soft-tissue nodule or mass inside the bile ducts. Conclusion Invasion of major intrahepatic ductal structures by HCC will present corresponding CT imaging features. Contrast-enhanced MDCT dual-phase scanning combined with appropriate image post-processing techniques can better evaluate the malignant invasion of major intrahepatic ductal structures.

Objective To explore the mixed infection of bacteria and viruses of community-acquired pneumonia (CAP) in children. Methods A total of 204 children with CAP were tested for sputum bacteria, viruses and atypical pathogen, and children with bronchoscope indications were performed with bronchoscope for alveolar lavage (BAL), and the BAL lfuid (BALF) was subjected to quantitative culture and intracellular bacteria detection. All the children were given antimicrobial sequential therapy. Results There were 153 strains of pathogenic bacteria isolated in 122 cases, the detection rate was 59.80%(122/204). Thirty cases were found with mixed bacterial and viral infections. BAL was performed on 70 cases, positive lavage germiculture were detected in 8 cases, of theses BALF specimen inducible co-stimulator (ICOS) positivity were found in 5 cases. Using BALF quantitative culture as control, the sensitivity of ICOS in the diagnosis of CAP was 37.50%and the speciifcity was 96.77%. In 30 cases of mixed infection with bacteria and viruses, 27 cases were younger than 5 years old, accounting for 90.00%. Duration of fever greater than 10 d in mixed infection group of children (43.33%, 13/30) was higher than that of the non-mixed infection group (23.12%, 40/173) (P??0.05). Average hospitalization time in children with mixed infection (13.5+1.5) d was higher than that with non-mixed infection (8.6+1.1) d (P?

Purpose To describe the clinical and pathological features of atypical vascular lesions (AVLs) after conservative surgery and radiation of the breast cancer,and to discuss the association with post-radiation angiosarcoma.Methods The clinical and pathological features in one case of AVLs was evaluated.The literatures were reviewed.Results The patient is a 57-yeAR~-old female who underwent a conservative surgery of the right breast because of a carcinoma.She received standard dose of radiation as adjuvant therapy.Three years later, multiple erythematous plaques developed around the former scar, which radiated to the nipple.Clinically,the plaques were considered as relapses of the carcinoma.However, fine needle aspiration gave negative results.Biopsy of one large plague revealed a circumscribed vascular lesion confined to the superficial dermis.It was composed of thin-walled anastomosing lymphatic vessels lined by attenuated endothelial cells.In focal areas, the vessels extended to the mid-dermis.Immunohistochemically, the endothelial cells were positive for CD31, CD34 and D2-40,with absent of α-SMA positive pericytes.Review of the breast tumor sections showed an invasive micropapillary carcinoma.Conclusions AVLs is a rare vascular lesion related with conservative surgery and post-radiation therapy of the breast.AVLs may represent as a precursor of breast angiosarcoma.Being familiar with the clinicopathologic characteristics of AVLs is important not only for the pathologists but also for the clinicians.

Objective The present study was to explore association of PvuⅡand XbaⅠpolymorphism in ER-?gene with genetic susceptibility for breast cancer without BRCAl/2 gene mutation. Methods 113 BRCA1/2 negative hereditary breast cancer patients from independent families and 113 agematched healthy control subjects were analyzed. Genotype analysis was conducted by polymerase chain reaction (PCR) and then DNA direct sequencing. The odd-ratios (OR) and 95% confidence intervals (CI) was calculated by unconditional logistic regression model. Results The frequency of PvuⅡpolymorphism CC(PP) ,CT(Pp) ,TT(pp) genotype in patients was found in 16 cases(14.2% ), 58 cases(51. 3% ) , and 39 cases (34. 5% ). The distribution of AA (xx) , AG (Xx) , GG (XX) genotype of XbaⅠpolymorphism were found in 76 cases ( 67. 2% ) , 34 cases ( 30. 1% ), and 3 cases ( 2. 7% ) among patients. Among premenopausal women, CT genotype of PvuⅡconfered a significantly increased risk for breast cancer compared with CC genotype ( adjusted OR = 2. 07; 95% CI, 0. 68 - 6. 30) ; Carriers of GG of XbaⅠhad a decreased risk for breast cancer (adjusted OR =0. 11; 95 % CI, 0. 01 - 1. 27) compared with AA genotype. Furthermore, combined analysis of two polymorphisms indicated individuals carrying PvuⅡCT and XbaⅠAA genotype were at increased risk for breast cancer as compared with those with PvuⅡCC and XbaⅠGG genotype (Oft = 11.43, 95% CI, 1.12-116.7) among premenopausal women. Conclusions PvuⅡand XbaⅠpolymorphisms in ER-?gene could be a candidate locus for low penetrance breast cancer susceptibility in Chinese population, especially among premenopausal women.

Objective To establish a doxycycline-controlled immortalized pre-cartilaginons stem cells (IPCSCs) strains, clone parathroid hormone-related peptide[PTHrP(1-36)] gene and construct re- sponsive plasmid, pTRE-PTHrP (1-36). Methods Plasmid pTet-on was transfected into IPCSCs by using LipoinfectaminTM 2000 and then the stable clones were obtained by G418 screening. The doxycyc- line was added into the medium of monoclonal cells that were transiently transfected with plasmid pTRE- 2Hyg-Lue. The total RNA was extracted from PCSCs and the PTHrP(1-36) gene obtained by RT-PCR method. Then, the PTHrP (1-36) gene was subcloned to plasmids of Tet-responsive element with the se- lection marker of hygromycin pTRE-2Hyg to construct recombinant eukaryotic expression plasmid pTRE- PTHrP(1-36). After transferred into E. coli-DH5α, the clone was amplified, the recombinant plasm0ids were purified and identified by double-enzyme digestion. Results The doxycycline induced IPCSCs line was obtained, with 50 times higher than the non-induced cell line. Double enzyme digestion analysis and sequencing showed that the target gene was cloned into recombinant plasmid. Conclusions The induced IPCSCs line can be used to highly express alien genes. The responsive plasmid containing PTHrP (1-36) gene may be premising for rigorous control of PTHrp (1-36) gene expression.

Objective To investigate the effects of N-acetylcysteine (NAC) pretreatment on the liver function and mRNA and protein expressions of nuclear factor-KB (NF-KB) in brain-dead BA-Ma mini pigs. Methods The brain-dead model was established by increasing intracranial pressure by a modi-fied, slow and intermittent way. A total of 15 BA-Ma mini pigs were randomly and equally divided into three groups (five in each group), ie, control group (Group C) : treated only with opening and closing abdomen after anesthesia; group without NAC treatment (group B): brain-dead models without use of NAC; NAC treatment group (Group N): 1 and 12 hours after establishment of brain-dead models, 200 mg/kg NAC was added into 100 ml normal saline and intravenously transfused. Levels of ALT and AST in serum as well as TNF-α, IL-1β and IL-6 were determined at 3,6,12, 18,24 hours after brain death. The changes of liver tissues were observed by HE staining under a light microscope, the uhrastruc-rural changes of liver tissues observed under electron microscope, the expression of NF-KB detected by immnohistochemistry and change of NF-KB mRNA by RT-PCR. Results (1) Compared with Group C, serum ALT and AST began to increase at 12 hours after brain death, but IL-1β, IL-6 and TNF-α be-gan to increase three hours after brain death in Groups B and N. mRNA and protein expressions of NF-KB in Groups B and N began to increase six hours after brain death, when Group B increased more sharply than Group N, with statistical difference (P<0.05). (2) At 12 hours after brain death, injury of liver cells in Group B was severer than that in Group N. Conclusion NAC can inhibit the mRNA and pro-tein expressions of NF-KB, decrease the release of inflammatory factors and hence protect the hepatic structure and function during brain death.

Objective To explore surgical opportunity and management of high-energy Pilon fractures.Methods Twenty-five cases of the high-energy Pilon fractures were treated with anatomic type plate one-staged or ses of type III fractures.8 cases were open fractures and 17 cases were close fractures.8 cases open fractures and 6 cases close fractures were treated with anatomic type plate one-staged.11 cases close fractures with serious soft tissue swell were treated two-staged delayed.The combined fibular fractures were fixed accordingly.All cases were followed up for 32 months after operation in average( range 17 to 76 months).Results According to Mazur's criteria,the surgical result was evaluated as excellent in 10 patients,goed in 11 ,fair in 3 and poor in 1.Postoperative complication ineluded infection in 2 cases,necrosis of skin in 1 case and traumatic arthritis of the ankle joint in 2 cases.Conclusion In order to get a satisfactory result,it is important to choose the right timing of surgery and correct procedure in high-energy Pilon fracture.