[ABSTRACT]OBJECTIVETo assess the upper airway and related structures in different patterns of the upper airway obstruction on cine magnetic resonance (CMR) imaging in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).METHODSCMR images of upper airway were obtained in 30 male patients with severe OSAHS during waking state and natural sleep. The midsagittal plane images were obtained. Patients were classified into 3 groups based on the upper airway obstruction patterns at apnea events and the reference data of the upper airway were measured.RESULTSDuring natural sleep, the diameter of retropalatal region, retroglossal region, retroepiglottic region and the length of suprahyoid muscles were significantly shorter than those during waking state (P<0.01). The maximum angle between the suprahyoid muscles and the apex of the tongue during natural sleep was significantly larger than that during waking state (P<0.01). During wakefulness, there was a significantly difference in the diameter of retropalatal region among 3 obstruction patterns (P<0.01). During natural sleep, there were statistical difference in the diameter of retropalatal region and the upper tongue, the angle between the hard palate and soft palate, the maximum angle between the suprahyoid muscles and the apex of the tongue, and their change values among 3 obstruction patterns (P<0.05). CONCLUSIONThe measurements of the upper airway and related structures on CMR imaging in OSAHS patients could provide useful information in assessing upper airway.

Liver transplantation,a unique effective treatment for end-stage liver diseases,has already been applied in clinical practice for more than half a century.But the shortage of donor liver source has been the bottleneck limiting its development.How to determine the tiny minority donor liver quality to guarantee the prognosis of transplant patients becomes a hot focus for current research.Brain death causes patho-physiological changes of body organs,including liver.How to carry out related pathological and serologic tests to determine the safety of the donor liver is a very important issue.In this paper,the articles published in recent years were overviewed and analyzed to summarize the evaluation index of donating organ quality.We hope this paper may benefit the treatment through ensuring an effective evaluation on the donor liver in the future.

Objective To study the efficiency of the first time platelet transfusion in patients with blood diseases.Methods Investigate the effect of platelet transfusion in 87 patients with blood diseases.All the patients were transfused 10U platelet (platelet≥2.5×1011 ).Observe CCI after platelet transfusion and analyse the influence factors to the efficiency of the first time platelet transfusion such as the kind of diseases,splenomegaly,fever,age and sex.Results After platelet transfusion,66 patients (75.9 ％) were effective.The efficancy rates were 80.0 ％,78.1％,65.2 ％,82.3 ％ in AA,ITP,AL,MDS (x2=2.88,P＞0.05).In 31 patients with a fever and infaction the efficancy rate was 58.1％,but it was 85.7％ in 56 patients without a fever and infaction (x2=8.3308,P＜0.01).The efficancy rate in 59 patients with non-splenomegaly was 86.4 ％.It was higher than that in 28 patients with splenomegaly which was 53.6％(x2=11.2033,P＜0.01).The efficancy rate was 76.0％ in male patients and it was 75.7 ％ in female patients (x2=- 0.0012,P＞0.05).The efficancy rate was 74.5 ％ in young group (＜60 years old)and 77.8 ％ in old group (≥60 years old)(x2=0.1231,P＞0.05).Conclusion Fever and splenomegaly are the influence factors to the efficiency of the first time platelet transfusion.

OBJECTIVE To detect the expression of the Glucocorticoid receptor-?(GR-?)mRNA in nasal polyp and normal nasal mucosa and investigate the route of nasal drug administration in patients of nasal polyp. METHODS The expression of GR-?mRNA in 101 samples of nasal polyps and 31samples of normal nasal mucosa was examined by using Fluorescent quantitative PCR .RESULTS The level of GR-?mRNA in normal nasal mucosa(135.4? 5.25)?104 copy /?g were significantly higher than that in nasal polyps(23.5?12.1)?104 copy/?g . CONCLUSION Because of the low expression of GR-?mRNA in nasal polyps,the route of nasal drug administration in patients with nasal polyps may be in the part of normal mucosa,not in the mucosa of nasal polyps of the nasal cavity.

Biliary complication (BC) after liver transplantation has attracted increased attention from a clinical and research perspective.BC,which affects the long-term outcome of the liver transplant,includes diseases of biliary stricture,biliary obstruction,biliary fistula,and many more that need an operation or interventional therapy.The occurrence of these diseases is related to the surgical operation,biliary tract variation,vessel injury,and quality of the donor graft.This article reviews BC and its etiology,diagnosis,and therapy in order to help future clinical and experimental studies.

Adult ; Atypical Hemolytic Uremic Syndrome ; etiology ; Female ; Glomerulonephritis, IGA ; complications ; Humans ; Puerperal Disorders ; etiology

Auto liver transplantation (ALT) has been tremendously popular in hepatic surgery for the liver masses due to lack of enough donor for allogeneic transplantation of liver.But ALT remains stagnant because it is technically more difficult than liver transplantation.Much difficulties in this field lying ahead.Related surgical technical requirements for surgeons operating ALT,complications,difficult liver resection,hypothermic liver perfusion,veno-venous bypass,ex vivo ECMO perfusion and liver trim,assess the quality and volume of autoplast,autoplast implant and vascular anastomosis.On the other hand,the therapeutic effect largely depends on the intraoperative vascular separating range,the location and size of the tumor,the scope of lymphoid infiltrates by neoplast,the intubation site for perfusion and the sequence of opening the occlusion vessel.Thus,it's necessary to set up a scientific,normative ALT procedure to improve the therapeutic effect and prognosis.

Objective To preliminarily investigate the clinical features and efficacy of surgical treatment of moyamoya syndrome in patients w ith hyperthyroidism. Methods From December 2002 to April 2013, 41 patients w ith moyamoya syndrome based on the disease of hyperthyroidism admitted to the Department of Neurosurgery, the 307th Hospital of PLA w ere analyzed retrospectively. The clinical data w ere colected, including sex, age of onset, initial symptoms, progress symptoms, imaging features, Suzuki staging, and surgical efficacy, and they w ere compared w ith the clinical data of the patients w ith moyamoya disease treated at the same time. Results The ratio of male to female w as about 1∶4 in moyamoya syndrome patients w ith hyperthyroidism. The peak age of onset w as 25 to 34 years old. Compared w ith the patients w ith moyamoya disease at the same period, the proportion of patients w ith cerebral infarction as initial symptom w as higher in the moyamoya syndrome group ( 39.0% vs.24.2%; χ2 = 4.796, P =0.029), more patients had symptomatic progression (46.3% vs.25.4%; χ2 =9.207, P =0.002), and the proportion of of patients w ith cerebral hemorrhage as initial symptom w as low er ( 2.4% vs.14.6%; χ2 = 4.829, P =0.028). Thirty-seven patients w ho received encephalo -duro-arterio-synangiosis (EDAS) w ere folow ed up for 43 ± 19 months. The results show ed that the clinical symptoms of 31 patients had different degrees of improvement. Conclusions Moyamoya syndrome of hyperthyroidism is more common in w omen. The risk of cerebral infarction is higher and more prone to have disease progression. The efficacy of EDAS is better for controling the progression of moyamoya syndrome in patients w ith hyperthyroidism.

Objective To investigate the correlation of the expressions of advanced glycation end products(AGE) and the receptor for advanced glycation end products(RAGE) in serum and placenta with the pathogenesis of preeclampsia. Methods From December 2013 to June 2014, 32 women with severe preeclampsia who received cesarean section in the Affiliated Hospital of Qingdao University were recruited in the study, defined as the severe preeclampsia group. 30 healthy pregnant women who received cesarean section in the same hospital were recruited as the control group. ELISA was used to measure the maternal serum AGE, soluble receptor for advanced glycation end products (sRAGE) and tumor necrosis factor-α(TNF-α) in these women. Furthermore, ELISA was also used to measure AGE and TNF-α in the placenta. The localizations of AGE and RAGE protein in placentas were detected by immunohistochemical SP method. RAGE and TNF-α mRNA expression in placentas were measured by real-time quantitative PCR. AGE, RAGE and TNF-αprotein expression in placentas were measured by western blot, respectively. Results (1) The serum levels of AGE,sRAGE and TNF-αin the severe preeclampsia group were (538 ± 75),(367 ± 86) and (322 ± 40) ng/L,respectively. They were significantly higher than those in the control group[(454 ± 50), (286 ± 35) and (270 ± 35) ng/L, respectively](P<0.05). The levels of AGE showed positive correlation with the levels of TNF-α(r=0.588,P<0.05),while the levels of sRAGE showed no correlation with TNF-α(r=-0.041, P>0.05). (2) In the severe preeclampsia group, the levels of AGE and TNF-αin placentas were (500 ± 82) and (334 ± 57) ng/L, which were higher than those in the control group [(431 ± 74) and (263 ± 46) ng/L, respectively](P<0.05). The levels of AGE showed positive correlation with the levels of TNF-ɑ(r=0.406,P<0.05). (3)AGE and RAGE protein mainly located in the syncytiotrophoblasts, macrophages and vascular endothelial cells in the placentas of the two groups. AGE expressed mainly in the cytoplasm, and RAGE expressed in the cytoplasm and cell membranes.(4)RAGE and TNF-αmRNA expression in the placentas of the severe preeclampsia group were 12.6 ± 4.6 and 10.4 ± 2.4, which were significantly higher than those in the control group (0.9 ± 0.4 and 3.5 ± 0.9,P<0.01). (5) The expressions of AGE、RAGE and TNF-αprotein in placentas of the severe preeclampsia group were 0.68 ± 0.06, 0.82 ± 0.08 and 0.76 ± 0.08. All were significantly higher than those of the control group (0.46 ± 0.05,0.42 ± 0.09 and 0.52 ± 0.07;P<0.01). Conclusions The levels of AGE and RAGE in serum and placentas elevated in the severe preeclampsia group, and the expression of TNF-αalso elevated. These indicated that AGE and RAGE might be involved in the systemic inflammatory response and local inflammatory response in placentas, and then caused the preeclampsia.

Objective To examine the metabolic variations in liver after 30 min warm ischemic injury,and the effect of hypothermic machine perfusion on the metabolism in rats.Methods 40 SD male rats were randomly divided into 4 groups:Group A,the liver underwent warm ischemia for 0 min and cold storage (CS) for5 h; Group B,the liver was treated by warm ischemia for0 min,CS for4 h and then machine perfusion (MP) for 1 h; Group C,the liver suffered from warm ischemia for 30 min and CS for 5 h; and Group D,the liver was treated by warm ischemia for 30 min plus CS for 4 h plus MP for 1 h.During the MP process,the perfusion resistance index was recorded every 10 min,and the liver glycogen content and malondialdehyde (MDA) value were also detected.Results The hepatic glycogen content decreased after MP treatment,but there was no statistical significance (P ＞ 0.05).No differences on MDA contents was found between Group A and B (P ＞ 0.05),while MDA in Group D was significantly higher than that in Group C (P ＜ 0.05).After hypothermic MP treatment,the liver resistance index value was significantly reduced.Conclusion MP could reduce the resistance index but increase metabolic rate in liver undergoing warm ischemic injury,thus producing more lipid peroxides.