Objective To analyze the diagnosis and treatment of iliac pseudoaneurysms following renal transplantation.Method The data of two patients with pseudoaneurysm who underwent kidney transplantation were retrospective analysied.Result One case with pseudoaneurysm received transplant nephrectomy,and pathological examination diagnosed mucoraceae infection; the other patient received endovascular treatment and amphotericin B therapy,endly died of hemorrhagic shock.Conclusion The development of pseudoaneurysms at the kidney transplantation recipients with the same donor results in high rates of mucormycosis.They should take anti-fungus therapy and operation as early as possible.

Objective To quantitatively analysis the aortic valve leaf anatomical characteristics in aortic regurgitation(AR) patients by real-time three-dimensional transesophageal echocardiography (RT-3D-TEE),and screening the parameters which significantly affect AR to further reveal the mechanism of AR.Methods 32 patients with AR were enrolled as AR group and 20 cases of non-AR people were involved as control group.RT-3D-TEE was using to collect images in two groups and offline analysis was performed.4 sets of parameters of the aortic valves(left coronary valve,right coronary valve,and non-coronary valve):leaflet edge length(LL,RL,NL),leaflet height (LH,RH,N H),leaflet length/height ratio (LRa,RRa,NRa),leaflet tip plane distance(LTH,RTH,NTH) were acquired.Parameters of two groups were compared,and the parameters were incorporated into the logistic regression model,then the ROC curves were obtained.Results ①Compared with the control group,LL,RL,NL,RH,LRa,NRa,RRa in AR group increased (P ＜ 0.05),while the rest parameters had no statistical differences (P ＞0.05).②Multivariable logistic regression model gradually screening of the significant factors influencing the reflux,and as a result RL and RTH had significant influence on AR,P values were 0.001,0.011.③The ROC curve analysis showed that the area of RL or RTH curve were both greater than 0.5,which were 0.811 and 0.605 respectively.Conclusions The free edge length and free edge length/height ratio have changed unbalanced.Furthermore,right coronary valve parameters changed significantly,and this might be one of the possible mechanism of AR.

We used metabolomics to investigate the ability of a traditional Mongolian medicine called modified Tabusen-2 (MT-2) to improve kidney yang deficiency (KYD) in rats. All animal experiments were conducted under the guidance and standards of the Medical Ethics Committee of Inner Mongolia Medical University. SD rats were divided into 6 groups of six rats: a normal group, a model group, Jinkuishenqi pill administration group (1.26 g·kg^-1), and MT-2 administration in high-, medium- and low-dose groups (1.512, 0.756, and 0.378 g·kg^-1). KYD was established by intramuscular injection of hydrocortisone (HC) and biochemical indicators and clinical characterization was used to confirm that KYD was established. All groups received intragastrically administered drug (Jinkuishenqi pill or MT-2) or saline. Serum from each group was collected after 8 weeks and analyzed by UPLC-Q-exactive-MS to measure various biochemical indicators. The biomarkers affected by MT-2 were identified and the metabolic pathways of KYD regulated by MT-2 were analyzed by metabolomic analysis. The results show that MT-2 can decrease serum creatinine (Cr) in KYD rats and significantly increase (P<0.05) the content of thyroid stimulating hormone (TSH) and luteinizing hormone (LH). In serum samples, 38 biomarkers such as corticosterone, L-phenylalanine, and DL-tryptophan were measured as possible indicators for disease development in KYD rats. MT-2 lowered 18 biomarkers of KYD, including corticosterone, deoxycorticosterone, and L-phenylalanine, and altered 13 related metabolic pathways including phenylalanine, tyrosine and tryptophan biosynthesis, phenylalanine metabolism and steroid hormone biosynthesis, resulting in an overall improvement in KYD. MT-2 appears to be important in improving KYD in rats mainly by regulating metabolites such as amino acids, steroids and lipids.

OBJECTIVETo investigate the changes of Cdc42 expression under estrogen stimulation, and to explore the signaling pathway of intracellular material transportation caused by estrogen.

METHODSMTT was used to test the drug sensitivity of cells. Real-time PCR was used to evaluate the expression of Cdc42 mRNA. The amount of ADM accumulated in MCF-7 cells was detected by flow cytometry. The protein levels of active-Cdc42 and Total-Cdc42 were measured by Western blot.

RESULTSIC(50) of ADM in MCF-7 cells was increased from (0.098 ± 0.011) µg/ml to (0.134 ± 0.130) µg/ml (P < 0.05) after estrogen stimulation. The amount of ADM accumulated in MCF-7 cells was reduced from 7.253 ± 0.310 to 3.233 ± 0.313 (P < 0.05). All of Cdc42 mRNA, active-Cdc42 protein and total-Cdc42 protein were increased (P < 0.05). After the treatment with siRNA, the IC(50) of ADM in siRNA group was decreased to (0.057 ± 0.017) µg/ml (P < 0.05) compared with that in the control group. The amount of accumulated ADM was significantly increased in the siRNA group, and all the expression levels of Cdc42 mRNA, active-Cdc42 protein and total-Cdc42 protein were decreased in the siRNA group (P < 0.05).

CONCLUSIONSEstrogen enhances the drug resistance in breast cancer cells. The mechanism of this effect may be via the enhancing Cdc42 expression and decreasing the accumulation of chemotherapeutic drugs in the cancer cells.

Antibiotics, Antineoplastic ; metabolism ; pharmacology ; Breast Neoplasms ; genetics ; metabolism ; pathology ; Cell Line, Tumor ; Doxorubicin ; metabolism ; pharmacology ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Estrogens ; pharmacology ; Female ; Humans ; Inhibitory Concentration 50 ; RNA Interference ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; genetics ; Transfection ; cdc42 GTP-Binding Protein ; genetics ; metabolism

OBJECTIVETo explore the necessity of the central region cervical lymph node dissection for patients with papillary thyroid carcinoma.

METHODSClinical data of 457 papillary thyroid cancer patients underwent bilateral thyroidectomy with cervical lymph node excision from June 2003 to September 2007 were retrospectively reviewed. There were 86 male patients and 371 female patients. The age was 17 to 73 years old.

RESULTSThere were no death for operation or in hospital. The total rate of central region cervical lymph node (VI region) metastasis was 59.1% (270/457), and bilateral metastasis was 42.2% (114/270). The total rate of III + IV region cervical lymph node metastasis was 29.8% (136/457). For unilateral papillary thyroid cancer, when tumor diameter over 1 cm and tumor breaking through thyroid caps, the central region cervical lymph node metastasis was 64.5% (178/276) and 81.6% (120/147) respectively. When the tumor diameter < or = 1 cm and tumor confining in thyroid, central region cervical lymph node metastasis was 23.4% (11/47) and 39.2% (69/176) respectively. There were 5 cases with lymph node jumping metastasis. During the follow-up of 7 to 59 months, 1 case died of lung metastasis. Four cases occurred local recurrence, 3 cases occurred distant metastasis. There was no case of hypothyroidism under the thyroxine replacement therapy.

CONCLUSIONSFor papillary thyroid cancer, the most common cervical lymph node metastasis is central region. It is necessary to dissect bilateral central region lymph node following the original surgical procedures.

Adolescent ; Adult ; Aged ; Carcinoma, Papillary ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Neck Dissection ; methods ; Retrospective Studies ; Thyroid Neoplasms ; pathology ; surgery

OBJECTIVETo analyze the indication of reoperation of thyroid cancer and to explore the timing, surgical pattern of reoperation.

METHODSProtocols of 72 patients underwent reoperation of thyroid cancer from June 2003 to August 2006 were reviewed retrospectively. Causes for reoperation were as follows: residue of the tumor locally as the inappropriate initial operation; local recurrence and cervical lymph node metastasis; before (131)I ablation which differentiated thyroid cancer with distant place metastasis. The reoperation style included residual lobectomy plus isthmus with single tumor below 2 cm, total thyroidectomy in most the other conditions and selective lymph node dissection in finding or suspected cervical lymph node metastasis.

RESULTSThe rate of residual in thyroid confirmed by postoperative pathology was 47.1% (32/68). The rate of residual in cervical lymph node was 81.4% (35/43). The rates of temporary and permanent laryngeal recurrent nerve injury were 5.6% (4/72) and 1.4% (1/72) respectively. The rates of temporary and permanent hypocalcemia were 26.4% (19/72) and 1.4% (1/72) respectively.

CONCLUSIONSInadequate operation, local recurrence and cervical lymph node metastasis of thyroid cancer need revision surgery undoubtedly. The optimal treatment was total thyroidectomy and level VI, VII central compartment lymph node dissection plus intraoperative frozen-section evaluation.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neck Dissection ; Reoperation ; methods ; Retrospective Studies ; Thyroid Gland ; pathology ; surgery ; Thyroid Neoplasms ; pathology ; surgery ; Thyroidectomy ; methods

OBJECTIVETo establish the norms of Sub-Health Measurement Scale Version1.0 (SHMS V1.0) for Chinese civil servants.

METHODSWe sampled a total of 15 000 civil servants form Tianjin (north China), Guangdong (south China), Anhui and Hunan (central China), Xinjiang (northwest China) and Shenyang (northeast China) to perform the spot trial, and established the mean, percentile and threshold norms based on the characteristics of SHMS V1.0 scores for Chinese civil servants.

RESULTSThe established norms based on the average scores of SHMS V1.0 showed a mean score of 66.55∓12.36 for young male subjects (below 40 years), 67.42∓12.40 for older male subjects, 66.22∓11.81 for female subjects younger than 40 years, and 65.94∓11.91 for older female subjects. The threshold norms of SHMS V1.0 divided 5 health states, namely disease, severe sub-health, moderate sub-health, mild sub-health and healthy states according to the Mean∓SD and Mean∓0.5SD of the converted scores. The 4 cut-off points were close to the 15th, 30th, 70th and 85th percentile scores of SHMS V1.0.

CONCLUSIONWe have established SHMS V1.0 norms for Chinese civil servants, which facilitates further investigation of the incidence of sub-health state and its contributing factors in civil servants.

Adult ; China ; Female ; Health Knowledge, Attitudes, Practice ; Health Promotion ; methods ; Health Status ; Health Status Indicators ; Humans ; Male ; Middle Aged ; Reference Values ; Surveys and Questionnaires

OBJECTIVETo investigate the early diagnosis on iatrogenic injuries in distal part of common bile duct and the prevention of severe retroperitoneal infection.

METHODSFrom 1990 to 2004, 17 patients with bile duct injures in the distal part of common biliary tract were admitted. And the clinical data of the 17 cases were retrospectively analyzed.

RESULTSOf the 17 cases, the injuries of 15 cases were caused by the operation, and the injuries of the other 2 cases were caused in the process of removing the stone by endoscopic retrograde cholangiopancreatography (ERCP). The injuries of 14 cases were found during the operation, but the other one was not found in time. Before the operation, 16 cases were examined by B-type ultrasonography, 2 by MRCP and 6 by intraoperative choledocho-endoscope after the biliary tract exploration. Ten cases underwent perforating suture repair and T-tube drainage; 2 with Odd's sphincter incision and shaping; 2 with choledochojejunostomy; 1 with duodenum wall and bile duct repair and drainage. When the bile duct injured, the major findings during operation were bile duct explorer located out of the duodenum wall and bile duct, two or more than cleft in the distal part of common biliary tract found by choledocho-endoscopic examination, retroperitoneal edema and liquid accumulation found by irrigating water through T-tube, and/or retroperitoneal tissues stained blue by irrigating methylthioninium chloride through T-tube. The clinical manifestations after injuries were abdominal distention, abdominal pain, pain in the waist and back, fever and shock, et al. Thirteen cases were cured. And the syndromes included 1 case with intestinal fistula, 1 with incisional infection, 4 dead (3 died from infectious shock; 1 from bleeding in gastrectomy).

CONCLUSIONSThe postoperative clinical manifestations for iatrogenic injuries in the distal part of common biliary tract lack specificity, CT examinations are necessary to doubtful patients. Early diagnosis and timely management can obtain better results, and can effectively lower severe retroperitoneal infection. The perfect preoperative imaging examinations and intraoperative choledocho-endoscopic examinations before the biliary tract exploration maybe reduce iatrogenic injuries in the distal part of common biliary tract.

Adult ; Aged ; Common Bile Duct ; injuries ; surgery ; Female ; Humans ; Iatrogenic Disease ; prevention & control ; Intraoperative Complications ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Peritonitis ; prevention & control ; Radiography ; Retrospective Studies

OBJECTIVETo summarize the reoperation experiences in treatment of massive rebleeding after subtotal gastrectomy for bleeding gastroduodenal ulcer.

METHODSFrom 1980 to 2002, clinical data of 26 cases with massive rebleeding after subtotal gastrectomy for bleeding gastrorenal ulcer were analyzed retrospectively.

RESULTSPreoperative gastroscopy was performed in 6 cases, intraoperative gastroscopy in 11, and preoperative superselective angiography in 2 cases. Eleven cases with left ulcer or post- bulb ulcer bleeding underwent resection of the left ulcer or longitudinal incision of the duodenal descending part and direct hemostasis. Thirteen cases with anastomotic stoma bleeding underwent local suture hemostasis or resection of the stoma plus Billroth II or Roux- en- Y gastrojejunostomy. Two cases with gastric bleeding received reexcision of the stomach remnant. Twenty- four cases (92.3% ) were cured and 2 cases (7.7% ) died of gastric bleeding.

CONCLUSIONPreoperative superselective angiography and intraoperative gastroscopy are beneficial to clarify the bleeding position and causes for massive rebleeding after gastrectomy. It is very important to select proper operative method to prevent postoperative rebleeding.

Adult ; Aged ; Aged, 80 and over ; Angiography ; Female ; Gastrectomy ; adverse effects ; Gastrointestinal Hemorrhage ; surgery ; Humans ; Male ; Middle Aged ; Peptic Ulcer ; surgery ; Postoperative Hemorrhage ; surgery ; Retrospective Studies

OBJECTIVETo establish the methods of calculating and analyzing the multi-coefficient of variation significance test for the toxicology study.

METHODSThe paper aimed to confirm the significance level with the method of Bonferroni and then compared the methods of calculating and analyzing of the experiment groups with the control group respectively.

RESULTSThe significance level of multi-coefficient of variation significance test was confirmed as alpha1=0.0167. Compared with the control groups, the activity of ALT in serum both in 30 mg/kg and 60 mg/kg groups did not change in the average significance test, which was not statistically significant (P>0.05), while it changed in the variation significance test, which was of statistical significance (P<0.0167). The activity of AST in serum in 60 mg/kg group did not change in the average significance test (P>0.05), while it changed in the variation significance test (P<0.0167).

CONCLUSIONThe complete changes of the indexes can only be shown by use of both the average significance test and the variation significance test together.

Alanine Transaminase ; blood ; Animals ; Aspartate Aminotransferases ; blood ; Disease Models, Animal ; Female ; Lead Poisoning ; enzymology ; Rats ; Rats, Wistar ; Statistical Distributions