Adolescent ; Arteriovenous Malformations ; Female ; Humans ; Portal Vein ; abnormalities

Adult ; Aged ; Antihypertensive Agents ; therapeutic use ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypertension ; drug therapy ; Male ; Middle Aged ; Phytotherapy

Objective To investigate the scope of application of precise hepatectomy and its value.Methods The clinical data of 112 consecutive patients with liver neoplasm who received hepatectomy at Renji Hospital from November 2006 to March 2009 were retrospectively analyzed.Precise hepatectomy technique was applied to 88 patients(precise group),whereas pringle maneuver was applied to the rest 24 patients(prince group).Patients in precise group had undergone lobectomy,segmentectomy or local resection,while patients in pringle group received segmenteetomy or local resection.The perioperative conditions of patients in the 2 groups were compared via Fisher exact probability and l test.Results No perioperative mortality,hepatic failure,reoperation due to massive hemorrhage or bile leakage was observed.The blood transfusion rate,blood loss,postoperative total bilirubin(Tbil),prothrombin time(PT)were 7%(2/29),220 ml,20 μmol/L,13 seconds in patients who received segmentectomy and local resection in precise group,and were 4%(1/24),210 ml,19μmol/L and 13 seconds in patients who received segmentectomy and local resection in pringle group,with no significant difference(t=0.248,0.263,0.246,P>0.05).The operation time,postoperative white blood cell (WBC)count.alanine aminotransferase(ALT)value and fever incidence were 60 minutes,7.5×10~9/L,66 U/L,10%(3/29)in patients who received segmentectomy and local resection in precise group,and were 15 minutes,14.0×10~9/L,335 U/L and 42%(10/24)in patients who received segmentectomy and local resection in pringle group,with significant difference(t=4.962,4.961,4.959,P<0.05).In precise group,the blood transfusion rate,postoperative WBC count,ALT value.PT and fever incidence were 9%(4/45),8.3×10~9/L,153 U/L,17 seconds and 13%(6/45)in patients who received Iobectomy,and were 12%(5/43),8.2×10~9/L,133 U/L,14 seconds and 14%(6/43)in patients who received segmentectomy or lncal resection,with no significant difference (t=1.652,1.225,1.236,P>0.05);the blood loss,operation time and postoperative Tbil level were 350 ml,250 minutes and 32μmol/L in patients who received lobectomy.and were 240 ml,150 minutes and 21 μmol/L in patients who received segmentectomy or local resection(t=4.915,4.967,4.829,P＜0.05).Conclusions Precise hepatectomy can decrease damage to patients,but it should be applied in selected patients according to the tumor location and the excision range.Precise hepatectomy is recommended to be applied in lobeetomy.

Objective To explore the liver toxicities of the VDLD scheme in children with malignant tumor.Methods In a prospective trial,the levels of serum total protein,albumin, globulin,rate of albumin/globuin alanine aminotransferase,aspartate transaminase,gamma glutamyltranspeptidase,total bile acid and alkaline phosphatase were tested in children with malignant tumour before and after VDLD scheme,and compared with each other.Results The concentration of the serum total bile acid was significantly increased after VDLD scheme than before(P

Objective To investigate the variations of surface protein genes of avian influenza virus (AIV)before and after infecting mouse.Methods Mouse lung tissue was infected with A/Goose/Guangaong/NH/2003(H5N1)and the virus was isolated 12 hours and 9 days after replication in lung tissue of mouse.The isolated strains were amplified in embryonated chicken eggs,anti the virion RNA was transcribed into cDNA by reverse transeriptase.After amplification and purification,dideoxy-mediated chain termination was performed to detect synthetic oligonucleotide primers and DNA sequence was analyzed.Results The homology of nucleotide sequence for HA gene of three isolated strains was 99.6%-99.8%.and that of amino acid sequences was 99.3%-99.6%.The homology of nucleotide sequence for NA gene of three strains was 99.8%-99.9%.all of them were synonymous mutatinns.No variation was found in M gene.Conclusion After replication in mouse lung tissue,no significant mutation was found in the surface protein genes of AIV except some point mutations in HA genes.

Objective: Our purpose was to study the relationship between the Fas antigen expression and neuron apoptosis after cerebral ischemia. Methods: We detected the Fas antigen expression and neuron apoptosis dynamically in the animal models with cerebral ischemia by immunohistochemistry and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) method. Results: Fas antigen was positive after 30 minutes of ischemia and reached peak at 60 minutes. At the 24th hour, it began to decrease, and negative on the 3th day. While the positive cell for TUNEL method appeared after 60 minutes of ischemia, reached peak on 3 day, and decreased on 7 day. Conclusion: Neuron apoptosis after cerebral ischemia is closely related to the over-expression of Fas antigen.

Objective To evaluate endoluminal repair and preoperative management for acute Standford type B aortic dissection complicating massive hydrothorax. Methods The clinical data of 27 patients (23 males, 4 females) hospitalized from January 2003 to December 2008 were analysed retrospectively. The average age was 47 ±9 years (35 ～70). Eleven patients had bilateral huge hydrothorax (40. 7% ) , while 13 had left hydrothorax (48. 1% ) and 3 had right hydrothorax (11. 1% ) only, and in 2 of them with additional pericardial effusion (7.4% ). SaO2 was below 90% in all cases. All patients underwent emergency endovascular repair. For control of massive hydrothorax found by CT or chest fluoroscopy, puncture drainage or tube drainage were administrated postoperatively. Results All the 27 operations were successful, and there was no perioperative mortality. Three type Ⅰ and one type Ⅳ endoleaks occurred but disappeared in one month. Hydrothorax disappeared 28 days to 3 months postoperatively in all patients, of which 5 cases had puncture drainage (18.5%) and 1 case had tube drainage ( 3. 7% ). Mean follow-up was 30 ± 20 m ( 6 ～ 78 m ) after endovascular management. Complications included pleural thickening (6 of 27, 22. 2% ) , pulmonary atelectasis (2 of 27, 7. 4% ) , and lung consolidation combined with chest dent (2 of 27, 7. 4% ). Conclusions Emergency endovascular therapy is safe and effective for acute Stanford type B aortic dissection with massive hydrothorax. Drainage of hydrothorax after stent-graft deployment is a must for the patient suffering from severe respiratory failure.

Objective To investigate the effect of moderate pain on attentional bias towards emotional pictures among healthy subjects.Methods Thirty-two healthy college students aged from 17 to 26 (21.8±2.2;16 males and 16 females) participated in this study.A tourniquet was tied to each subject's left upper arm 1 to 2cm above the cubits horizontal grain.Pain was inflicted by inflating the tourniquet,and the pressure was maintained at 26.66kPa.While tourniquet was inflated (with pain) or not (no pain),each subject was asked to finish a pictorial dot-probe task with three kinds of pictures-emotionally positive,negative and neutral.In experiment 1,subjects performed the dot-probe tasks with the contralateral hand while the tourniquet was tied on the left upper arm without inflation.In experiment 2 the tourniquet was inflated until the subject completed the dot-probe task (for about 10min).The reaction times (RTs) and the error rates (Ers) in the recognition task were recorded,and the intensity of the subject's pain and discomfort were measured using a verbal rating scale.Results The subjects reported moderate to severe pain with the tourniquet inflated.The RT and ER data were analyzed using two-way analysis of variance (ANOVA) which showed a significant difference between the average RTs of the males (482±73ms without pain and 466±82ms with pain) and those of the females (536±90ms without pain and 519±100 ms with pain).The average ER was significantly different between the pain (2.38±1.49)％ and no pain (1.09±0.82)％ conditions in both groups.Holn-Sidak multiple comparison testing showed significant differences in both groups' average ER between the negative picture (3.81±1.73)％ and the positive picture (1.66±0.97)％,and between the negative and neutral pictures (1.68±0.8) ％ in the pain condition.Mild attentional avoidance was observed with the positive [pain condition (-5.1±4.8) ms and no pain (-4.6±4)ms] and negative pictures [pain condition (-3.43±6) ms and no pain (-0.79±4.1)ms],but no significant difference was found between the pain and no pain conditions.Conclusion The error rate in a pictorial dot-probe task is influenced by pain,especially with negative pictures.

Objective To analyze the current situation of traditional risk factors in acute myocardial infarction (AMI) patients with different age,and to explore the impact of different risk factors on AMI.Methods The personal clinical characteristics of 682 hospitalized AMI patients in CCU were recorded from October 2003 to October 2010 with a retrospective cohort study.The effect of smoking,hyperlipidemia,diabetes and hypertension on AMI was observed.Results Six hundred and thirteen patients were enrolled in the end,43 cases in young group,216 cases in middle age group,234 cases in older age group,120cases in old-old age group.(1) Compared with that in middle age group,older age group and old-old age group,the ratio of smoking and hyperlipidemia in young group was significantly higher(P ＜ 0.0125 or ＜ 0.001).The ratio of smoking in middle age group was significantly higher than that in older age group(P ＜ 0.001),and the ratio of hyperlipidemia between two groups had no significant difference (P ＞ 0.0125).The ratio of smoking and hyperlipidemia was significantly higher in middle age group compared with that in old-old age group(P＜0.001 or ＜ 0.0125).(2) The average age in smoking patients with AMI was (56.84 ± 13.00) years,which was significantly younger than that in non-smoking patients[(74.29 ± 10.57) years] (P ＜ 0.01).The average age in patients with hyperlipidemia suffering from AMI was significantly younger than that in patients with normal lipid level patients [(62.92 ± 15.04) years vs.(68.63 ± 13.93) years] (P ＜ 0.01).Conclusions Smoking and hyperlipidemia,especially smoking plays an important role in inducing AMI in young and middle age.Smoking cessation and lipid-lowering therapy is vital for reducing the occurrence of AMI in young and middle age.

Objective To explore the clinical characteristics and prognosis of congenital pulmonary artery sling (PAS) in children. MethodsThe clinical data of 38 children diagnosed with PAS during June 2009 and February 2015 were retrospectively analyzed. ResultsIn 38 PAS children, 35 cases (89.47%) were hospitalized for varying degrees of respiratory manifestations with recurrent cough (89.47%) and wheezing (84.21%) being the most common. The remaining 3 cases were found abnormal in routine preoperative examination and the diagnosis was confirmed after further examination. All 38 children were performed computer tomography angiography (CTA). Thirty-seven cases were diagnosed of PAS and diagnostic rate was 97.37%. One case was suspected of pulmonary dysplasia and diagnosed of PAS after operation. Twenty-six children received surgical treatment, of whom 25 children had pulmonary artery reconstruction (LPA). Seven children died during/after operation and 18 survived. The remaining 12 children received non-surgical treatment, of whom 9 died and 3 survived.ConclusionCardiac uhrasonography may reveal PAS in the early stage, while CTA is the best method for conifrmed diagnosis. LPA reconstruction is an important means of relieving left pulmonary artery oppression.