Ascites ; complications ; etiology ; Heart Failure ; complications ; etiology ; Hemochromatosis ; complications ; diagnosis ; Humans ; Middle Aged

Objective To study the different biomechanics surgical effects of posterolateral fusion , the transverse fusion and the interbody fusion. Method Scan CT was followed with preprocess of images. The Mimics , HyperMesh and Geomagic Studio Reverse engineering softwares were used to establish the modles of lumbar fusion , then the finite element computation was conducted by using the Abaqus finite element software. Result The EF of each lumbar modle was established , the EF of the interbody fusionwas rised evidently. After the fusion , the stress of the adjacent lumbar were also rised, among them the stress of the upper adjacent segment in tnterbody fusion was the most in extension and rotation , with statistical significance ( P < 0 . 05 ) . In the antexion the stress of the transverse fusion was the most, and the new type of posterolateral fusion least, three of them all hadstatistical significance (P<0.05). In the lateral flexion, they had no statistical significance (P>0.05). About the under adjacent sengment, in the extension and antexion, the stress of the interbody fusion was the most, and the new type of posterolateral fusion was the least, the three of them all haved statistical significance (P<0.05, respectively). In the rotation and lateral flexion, with no statistical significance (P>0.05). Conclusion After the fusion, the EF of the lumbar and the stress of the lumbar disc are all established, the interbody fusion is most, while the others are lower.

Objective To investigate the changes of calcium /calmodulin - dependent protein kinase Ⅱ (CAMKⅡD) gene expression in 3T3 - L1 preadipocyte diffe-rentiation and TNF - ? regulation of CAMKⅡD gene expression on matured adipocytes. Methods 3T3 - L1 preadipocytes were cultured and differentiated into adipocytes. The levels of CAMKⅡD gene mRNA expression at various times were evaluated by RT-PCR. Matured adipocytes were interfered with 0.1,1.0,10.0 ?g/L TNF - ? and the levels of CAMKⅡD gene mRNA expression were evaluated. Results The levels of CAMKⅡD gene mRNA expression in 3T3 - L1 adipocytes were significantly down- regulated at first day, compared with those at zero day (P0. 05). CAMKⅡD gene mRNA expression decreased significantly at 12 hours after treatment with 10.0 ?g/L TNF-?, treatment of matured adipocytes with TNF - ? did not have any regulation role on it. Conclusions CAMKⅡD gene is involved in the differentiation of adipocytes and related to the etiology of obesity. The changes in the level of CAMKⅡD gene mRNA expression during 3T3 - L1 preadipocyte differentiation may contribute to the differentiation and adipogenesis of adipocytes. It seems that TNF - ? does not have any regulation role on the expression of CAMKⅡD genes.

Object To develop a method for pharmacokinetics detection of chemical component in healthy volunteers' plasma administrated with Suxiao Jiuxin Wan, to provide the clinical experimental evidences for therapeutic drug monitoring (TDM) and the hypothesis of pharmacokinetics of traditional Chinese syndrome and recipe. Methods A GC FID method was established for rapid determination of borneol, tetramethyl pyrazine (TMP) content in healthy volunteers' plasma. After obtaining the blood sample at different time, the plasma concentration of borneol, TMP was detected, respectively. The data were processed with the software 3P97 to calculate the pharmacokinetics parameters. Results A good linear relationship of borneol, TMP existed in the plasma of healthy persons in the range of 20-420 ng/mL. Whole blood concentration time course of borneol and TMP in the group administrated with Suxiao Jiuxin Wan was fitted to be a one compartment model. Borneol and TMP in healthy persons were absorbed, distributed and excreted rapidly. Conclusion The GC FID method is sensitive, reliable and rapid, it can be used in pharmacokinetics study of borneol and TMP in vivo.

Background and purpose:Liver cancer resection and splenectomy are the main methods to treat hepatocellular carcinoma and hypersplenism. The aim of this study was to discuss the safety and feasibility of simultaneous radiofrequency ablation (RFA) and laparoscopic splenectomy (LS) for the treatment of small hepatocellular carcinoma with hypersplenism.Methods:Twenty-seven patients with small hepatocellular carcinoma and cirrhotic hypersplenism underwent RFA and LS. The clinical data were also analyzed.Results:The surgery was converted to an open surgery in 1 patient, while laparoscopic splenectomy in a hand-assisted manner was performed in 2 patients. There were 31 liver tumors treated with RFA. Blood loss were 110-900 mL (mean=320 mL). Operation time were 72-127 min (mean=107 min). Subcutaneous emphysema occurred in 1 patient, and pancreatic leakage in another patient. Nine patients developed ascites. one patient suffered from massive haemorrhage, and emergency operation was adopted to stop bleeding. This patient recovered well after operation. No death was found during the hospitalization. Conclusion:Combining RFA with LS for the treatment of liver cancer and hypersplenism is minimally invasive, safe, and feasible.

Objective To approach the evaluative effect of respiratory variation of superior vena cava peak flow velocity measured using transthoracic echocardiography (TTE) on fluid responsiveness in patients with mechanical ventilation.Methods A prospective cohort study was conducted.All mechanical ventilated critically ill patients whose fluid therapy was planned due to hypovolemia in Department of Critical Care Medicine of Beijing Tongren Hospital of Capital Medical University from April 2011 to April 2013 were enrolled.Volume expansion was performed with 500 mL Linger solution within 30 minutes.Patients were classified as responders if pulse pressure variation (PPV) increased ≥ 13％ before volume expansion.The respiratory variation in superior vena cava peak velocity was calculated as the difference between maximum and minimum values of velocity in peak A,peak S and peak D over a single respiratory circle,and their variations (ΔA,ΔS,ΔD) were also calculated.The receiver operating characteristic curve (ROC curve) was plotted to assess the evaluative effect of respiratory variation of superior vena cava peak velocity on fluid responsiveness.Results Twenty-seven patients were enrolled in this study.Volume expansion increased PPV ≥ 13％ happened in 14 patients (responders).The velocity of superior vena cava in peak A,peak S,peak D was significantly increased after volume expansion compared with that before volume expansion in responders [peak A (cm/s):34.6 ± 2.2 vs.31.3 ±2.1,t=-2.493,P=0.027; peak S (cm/s):39.1 ± 1.3 vs.35.3 ±2.1,t=-2.564,P=0.024; peak D (cm/s):28.1 ± 1.2 vs.23.3 ± 1.4,t=-4.995,P=0.000],but there was no significant difference in ΔA,ΔS and ΔD between before and after volume expansion.The ΔA,ΔS and ΔD were positively correlated with PPV (r＝0.040,P=0.854; r=0.350,P=0.074; r=0.749,P=0.000).The area under ROC curve (AUC) of peak S was 0.36 [95％ confidence interval (95％CI):0.11-0.52],but the AUC of ΔS was 0.68 (95％CI 0.47-0.89),the AUC of peak D was 0.41 (95％CI 0.19-0.63),but the AUC of ΔD was 0.95 (95％CI 0.86-1.00),so the aberration rate of superior vena cava in respiration was better than the flow rate in superior vena cava.When the cut-off value of ΔS was 20.7％ for predicting fluid responsiveness,the sensitivity was 78.6％ and the specificity was 61.5％.When the cut-off value of ΔD was 12.7％ for predicting fluid responsiveness,the sensitivity was 92.0％ and the specificity was 92.3％.Conclusion Respiratory variations in superior vena cava peak velocity measured by TTE could assess fluid responsiveness in patients with mechanical ventilation.

Objective To investigate the clinical significance of generalized epilepsy with febrile seizures plus(GEFS+ ). Methods The data of one family with GEFS+ were retrospectively analyzed by studying clinical manifestations, physical examinations, electroencephalogram(EEG), 24 hours dynamic EEG monitoring, et al. Some of the patients were examined by CT. Results Ⅳ 12, her chief complaints when admitted to hospital were frequent spasm for 3 days. She began to appear febrile seizures (FS) from 8 months after birth, and frequent generalized tonic - clonic FS appeared during that time. There were 36 people in 5 generations of the family including 14 patients (8 males and 6 females) ,aged from 4 years and 5 months to 82 years. FS presented in 8 cases (Ⅱ 2, Ⅲ1, Ⅲ4, Ⅲ6, Ⅳ1, Ⅳ11, Ⅳ17, Ⅴ2),febrile seizures plus(FS +) in 4 cases ( Ⅳ2, Ⅳ12, Ⅳ13, Ⅳ14), ES + and absence seizures in 1 case ( Ⅴ1 ), uncertain type in 1 case (Ⅰ2). The results of EEG indicated that 12 cases were normal and 4 cases with FS+ and 1 case with absence seizures had epileptic discharges. Apart form Ⅳ13, Ⅳ14 who were treated with magnesium valproate, the dosage for the other patients decreased, or medicine terminated or without medicine, and all the patients had no recurrence of seizures. The intelligence, movement development and neurological examinations of the family were all normal. Head CT scan of 3 cases were normal. Conclusions GEFS+ is autosomal dominant inheritance disease with conspicuous genetic heterogeneity and phenotypic heterogeneity. The apprehension of GEFS+ plays an important role in diagnosis and differential diagnosis of epilepsy in childhood.

Objective To explore the importance effect of circulating endothelial cells(CEC)in the pathogenesis of Henoch-Schonlein purpura(HSP)by determining the level of CEC in children with HSP,and to explore the relationship between CEC and therapeutic effect of HSP and the relationship between CEC and Henoch-Schonlein purpura nephritis(HSPN).Methods Sixty-six inpatients with HSP and 30 children as healthy control group were selected in the First Affiliated Hospital of Zhengzhou University from May to Dec.2008.The blood of all children,including the children in healthy control group,were sampled 1 mL in the early morning.And the CEC of all children were measured by flow cytometry method.The variation of CEC was analyzed in patients with HSP at acute stage and in healthy control group,in patients with HSP and in patients with HSPN,and in patients with HSP without renal damage at recovery stage and in patients with HSPN at recovery stage.SPSS 13.0 statistical software was used to analyze the data.Results CEC in patients with HSP at acute stage[(47.934 5?16.902 6)%]was significantly higher than that in healthy control group[(37.436 7?10.200 7)%](t=2.900 P0.05).CEC in patients with HSPN at recovery stage[(50.258 8?12.824 2)%]was significantly higher than that in patients with HSP without renal damage at recovery stage [(40.864 0?8.165 2)%](t=2.906 P

Objective To evaluate the quality status of recombinant human interferon α1b injection and find out some quality problems.Methods Totally 31 batches of recombinant human interferon α1b for injection and 11 batches of recombinant human interferon α1b injection from two enterprises were examined according to Chinese Pharmacopoeia Volume Ⅲ (2010),and the quality status of recombinant human interferon α1b injection was evaluated by statistical analysis of the results.Results All 42 batches of samples were qualified.The production process of each enterprise was steady.Conclusion At present the quality of recombinant human interferon αlb injection is generally good.The current standards are feasible,but the specified standard of osmolality needs to be improved.

Objective To evaluate the clinical efficacy and safety of domestic Sirolimus-eluting stents (Firebird) and imported Zotalimus-eluting stents ( Resolute) in the treatment of patients with unprotected left main coronary artery disease ( ULMCA) . Methods We retrospectively enrolled 76 patients with ULMCA treated by percutaneous coronary intervention (PCI) under the guidance of IVUS in our hospital. According to the different stents used in the procedure, the patients were divided into two groups: Domestic Sirolimus-Eluting Stents group (Firebird group, n = 42) and Imported Zotarolimus-Eluting Stents group (Resolute group, n = 34) . We analyzed the baseline characteristics, coronary artery lesion characteristics, stenting strategies and any changes in left ventricular ejection fraction ( LVEF) in both groups and investigated the long-term clinical outcomes. Results There were no significant differences in the baseline characteristics, the SYNTAX scores of the coronary artery lesion and the rate of complete revascularization between the two groups. Compared with that in Firebird group, there were more cases involving the distal left main (79. 4% vs. 45. 2% , P ﹤ 0. 05) and more patients using two stents strategies (29. 4% vs. 7. 1% , P ﹤ 0. 05) in the Resolute group. The change in LVEF post-PCI had no difference between the two groups. The patients were followed up for a mean of (23. 3 ± 10. 7) months. During the follow-up period, the occurrence of MACCE had no significant difference between the two groups. In the Firebird group, there were one sudden cardiac death, one nonfatal myocardial infarction, one stroke and five patients with recurrence of angina pectoris. In the Resolute group there were one sudden cardiac death, one target lesion revascularization and four patients with recurrence of angina pectoris. Conclusions Compared with the imported Zotalimus-Eluting Stents, the domestic Sirolimus-Eluting Stents are safe and effective in the treatment of patients with unprotected left main lesions under the guidance of IVUS. The two kinds of stent showed similar long-term clinical outcomes.