Objective To study the responsible arteries of duodenal ulcer hemorrhage and the significance of transcatheter arterial embolization.Methods There were 1 7 patients of massive bleeding of duodenal ulcer,in which 1 6 patients were diagnosed and 8 ca-ses were treated by endoscope initially.DSAs were performed at gastr-oduodenal arteries or their ramus in all patients.DSA signs were analysed by two salted docters together.At first the responsible ar-teries for duodenal ulcer hemorrhage were affirmed,and then endo-vascular embolization was performed.Results The responsible arteries for duodenal ampulla ulcer hemorrhage were the ascending duodenal artery(ADA)、the pancreaticoduodenal trunk(PDT)、the supraduodenal artery(SDA)and the retroduodenal artery (RDA).The responsible arteries for descendant duodenum ulcer hemorrhage were the anterior superior pancreaticoduodenal artery (ASPDA)and the posterior superior pancreaticoduodenal artery(PSPDA).The positive rate of bleeding that showed the signs of bleeding was 100%,the s-uccess rate of the operations was 100%,the complete efficiency ra-te of hemostasis was 88.2%,the par-tial efficiency rate of hemostas was 1 1.8%.Conclusion The responsible arteries of duodenal ulcer hemorrhage are multiples,which is important for guiding transcatheter arterial embolization of the responsible arteries of duodenal ulcer hemorrhage accurately.

BACKGROUND: Bone implant materials have been previously reported to be not coincident between inducing velocity of new bone formation and degradation velocity itself; therefore, the materials could not be completely degraded but formed into foreign substances. A novel artificial bone implant material, characterizing by well biocompatibUity, biodegradation, and biomechanics, is focused in biomaterials field recently.OBJECTIVE: To study the biodegredation of a novel bionic scaffold with nanostructure, i.e., poly (3-hydroxybutyrate-co-3-hydroxyvalerata)/sol gel bioactive glass (PHBV/SGBG), in vivo. DESIGN, TIME AND SETTING: A controlled animal experiment was performed at Animal Experimental Center of the Third Hospital affiliated to Sun Yat-sen University from May 2005 to October 2006. MATERIALS: PHBV/SGBG was provided by Materials Institute of South China University of Technology, and ethylene oxide was sterilized for preparation.METHODS: Eight hybrid dogs were used to make models of Ubia diaphyseal defect, having two defects on both left and right sides. The tibia diaphyseal defects at proximal part were considered as the control group, and those were not performed with any treatment; while, the tibia diaphyseal defects at distal part were considered as the experimental group, and PHBV/SGBG was fully implanted into the defect regions. Every two dogs were sacrificed at different time points of 2, 4, 8, and 12 weeks, respectively. MAIN OUTCOME MEASURES: In vivo biodogradation and osteogenesis were monitored under optic microscopy and electron microscope.RESULTS: The PHBV/SGBG scaffold had well biodegradation and rapid degradation velocity, and it began to degrade at two weeks after operation. The PHBV/SGBG scaffold was almost replaced by new bone tissues at 8 weeks after operation and completely degraded at 12 weeks after operation. In addition, the PHBV/SGBG scaffold had a good ability to induce new bone formation from edge to center. Whereas, surface depression in the defect region was still visible in the control group, cortical bone was not formed in embedded region of soft tissue; furthermore, electron microscopy demonstrated that calcium salt deposition was increased in the bone defect region, and the structure was tight; however, the defect was not completely repaired, and some voids were still visualized.CONCLUSION: The novel bionic scaffold, PHBV/SGBG, degrades fast in vivo to generate new bone tissues. The new bone regenerate accompanied by a fitting degradation of the novel bionic scaffold that achieve complete repair.

Objective To discuss the feasibility and clinical value of percutaneous transluminal stenting (PTS) for the treatment of central venous obstruction (CVO) in hemodialysis patients with arteriovenous fistula (AVF).Methods The clinical data of 10 hemodialysis patients with AVF complicated by CVO were retrospectively analyzed.Clinically,all patients presented as swollen hand syndrome.Preoperative or intraoperative digital subtraction angiography (DSA) was performed to determine the obstruction site,and based on the disease condition the appropriate surgical approach was employed.For patients having thrombus formation,catheter-directed thrombolysis (CDT) was carried out first.For patients having severe stenosis or occlusion of veins,pre-expansion with small diameter balloon was employed before PTS.For the remaining patients,PTS was directly performed.All patients were regularly followed up after operation.Results DSA showed that brachiocephalic vein occlusion and/or occlusion or stenosis of subclavian vein,internal jugular vein and superior vena cava were observed in 5 patients who had history of internal jugular vein catheterization,while localized severe stenosis of medial segment of AVF-side subclavian vein was detected in the other 5 patients who had no history of internal jugular vein catheterization.The technical success rate of PTS was 100％ (10/10).A total of 19 stents were implanted in the 10 patients.Seven months after the treatment,one patient developed in-stent re-stenosis,and PTS had to be carried out again.Primary patcncy rates at 6 months and 12 months after the treatment were 100％ (8/8) and 75％ (3/4) respectively.Conclusion In hemodialysis patients with AVF,CVO is mainly characterized by obstructive or severely stenotic lesions.PTS carries higher success rate with satisfactory short-term and mid-term effect,its complications are slight and mild,and the technique is safe and feasible.Therefore,PTS can be used as the preferred treatment method.

Objective:To explore the clinical effect ofpaishitang combined with tamsulosin hydrochloride on the patient with up per urinary calculi after extracorporeal shock wave lithotripsy (ESWL).Methods:120 cases with upper urinary calculi in our hospital from January 2015 to September 2016 were selected and divided into two groups according to the random number table,60 cases in each group.ESWL was given to both groups of patients and provided with tamsulosin hydrochloride postoperation,then paishitang were additionally given to the patients in the observation group.The clinical effect and changes of serum creatinine (Scr),neutrophil gelatinase as sociated lipocalin (NGAL),cystatin C (Cys-C) and glomerular filtration rate (GFR) levels before and after treatment were compared between two groups.Results:The total effective rate of observation group was 96.67％,which was 86.67％ in the control group,no signifi cant difference was found in the total effective rate between the two groups(P＜0.05).The stone discharge rate was 95.00％ in the observation group,which was significantly higher than that of the control group (P＜0.05);the incidence rate of renal colic was 6.67％,which was significantly lower than that of the control group(P＜0.05),the stone discharge time and the duration of hematuria were significantly shorter than those in the control group (P＜0.01).There was no significant difference in the recurrence rate between the two groups within one year (P＞0.05).The serum NGAL and Cys-C levels of both groups were gradually increased while the GFR levels were gradually decreased on the 1st,2nd day postoperation,but all the index mentioned above gradually recovered on the 3rd day postoperation.The levels of NGAL and Cys-C in the observation group were significantly lower than those in the control group on the 1st,3rd day postoperation while the GFR was significantly higher in the observation group than those of control group on the 1st,3rd day postoperation(P＜0.01).No significant difference was found in the Scr at different time points postoperation between two groups(P＞0.05).Conclusion:Paishitang combined with tamsulosin hydrochloride had significant clinical effect on thpatient with upper urinary calculus after ESWL and could effectively improve the renal injury induced by ESWL.

Objective To construct shRNA expression vector of SURVIVIN for RNAi-mediated therapy of lung cancer.Methods DNA templates of SURVIVIN shRNA were designed,synthesized and cloned into the shuttle vector to get recombinant plasmids.After plasmids were transfected into A549 cells,the one with the most repression was screened by means of RT-PCR.Then MTT and Western blot were done to ascertain whether the proliferation of A549 cells were inhibited and SURVIVIN was down-regulated.Results The recombinants were constructed and screened successfully.The proliferation of A549 cells and SURVIVIN expression were repressed.Conclusion Mediated by RNAi,SURVIVIN expression was down-regulated,which suggested a potential gene therapy of huaman lung cancer.

Objective To analyze the causes and management of the late complications after transurethral resection of the prostate (TURP) for benign prostatic hyperplasia. Methods The clinical data of 102 patients who were hospitalized for the late complications after TURP were analyzed retrospectively. Results The causes of readmission were residual prostatic hyperplasia for 32 patients (31.37%),bladder neck restriction for 22 patients (21.57%),urethral stricture for 18 patients (17.65%),hematuria for 15 patients (14.71%),epididymitis for 6 patients (5.88%),urinary tract infection for 4 patients (3.92%),carcinoma of prostate for 3 patients (2.94%),and neuropathic bladder dysfunction for 2 patients (1.96%). All patients were satisfied with their therapeutic efficacy after different treatments. Conclusion The main complications after TURP include residual prostatic hyperplasia,bladder neck restriction,urethral stricture and hematuria. Best therapeutic approach should be chosen according to different causes of the late complications after TURP.

Objective: To observe the inhibitory effect of gefitinib combined with DNA vaccine targeting EGFR against implanted Lewis tumors in mice.Methods: Chicken EGFR L2 domain and rabbit IgG Fc domain fusion pVAX1/cEGFR-rFc DNA vaccine was injected into mice and the titer of anti-EGFR in serum was determined by ELISA.The growth of Lewis cells was measured by MTT.Lewis lung cancer mouse models were established and were randomly divided into vaccine,gefitinib,gefitinib+vaccine,and control groups.The tumor volume and weight and survival of mice were examined in different groups.Results: The titer of anti-EGFR in mice vaccinated with pVAX1/cEGFR-rFc plasmid was 1∶1 000.The proliferation of Lewis cells in anti-EGFR combined with gefitinib was significantly inhibited compared with those in anti-EGFR and gefitinib groups(P

Objective Identification of anatomic structures are essential for totally thoracoscopic anatomic pulmonary segmentectomies, however sometimes the procedure are difficulty.This study was to assess whether three-dimensional computed tomography angiography(3D-CTA) could contribute to the preoperative arrangement of thoracoscopic complex segmentectomy.Methods Between September 2012 and August 2014, 29 patients were performed thoracoscopic complex segmentectomies under the guidance of preoperative 3D-CTA.The segmentectomies pattern were based on the nodules' diameter, location,and pathology.The targeted vessels and bronchus were marked in preoperative simulated segmentectomies.Results Of the 29 cases, 9 right upper lobe segmentectomies, 13 left upper segmentectomies, and 7 bibasilar segmentectomies were achieved, among which 6 subsegmentectomies were also inclued.The mean lesion diameter, operative time and intraoperative blood loss were(1.35 ± 0.80) cm, (190.53 ± 50.83) min, and (26.90 ± 32.24) ml respectively.Under the guidance of preoperative 3D-CTA , 8(27.5％) nodules were detected accurately, moreover 2(6.9％) aberrant arteries and 1 (3.4％) aberrant bronchus were observed.According to the marked vessels and bronchus preoperatively, 27 (93.1％) arteries, 25 (86.2％)veins,and 29(100％) bronchus were identified and dissected in the operation.Three cases converted to unplanned segmentectomies.No serious complications or death occurred.Conclusion 3D-CTA is an effective tool to enhance security and efficiency in thoracoscopic complex anatomical segmentectomy.

BACKGROUND:In closed fractures, the initial hematoma that is inclined to remove is seldom considered as the important reasons for bone healing. OBJECTIVE:To observe the mechanism and potential role of original fracture hematoma in fracture healing. METHODS:Ninety-six patients with closed fractures of the long bones undergoing open reduction and internal fixation were randomly divided into experimental group (n=48) and control group (n=48). In the experimental group, original fracture hematoma, 1.0-2.0 mL, was first taken out during the internal fixation and placed into a special sterile plastic bag; then, 3-4 pieces of hematomas were filed into the fracture site and sutured layer by layer. On the contrary, original fracture hematomas from the control group were discarded. Blood samples were extracted to detect the biochemical indicators at 1 month after internal fixation. X-ray examination was done at 1, 3, 6 months after internal fixation for observation of fracture healing. RESULTS AND CONCLUSION: X-ray films showed that the healing rate at 3 months after operation was 95% in the experimental group and 78% in the control group, and there was a significant difference between the two groups (P < 0.05). Levels of bone glaprotein, I-type precolagen carboxy terminus peptide and serum bone alkaline phosphatase were significantly higher in the experimental group than the control group (P < 0.01 orP < 0.05). These findings indicate that the original fracture hematoma can accelerate calus formation, promote bone induction, provide nutrition to the fracture site, and participate in revascularization. Therefore, the original fracture hematomas is one of the effectively therapeutic methods for union and nonunion of fractures.