Objective:To explore the clinical value of chest multi-slice computed tomography angiography (MSCTA) as a preoper-ative examination for lung cancer patients undergoing pulmonary lobectomy. Methods: Sixty lung cancer patients formed the study population and were randomly divided into 2 groups of 30 cases each. In the experimental group, CTA images of the tumors and pulmo-nary artery, bronchial artery, pulmonary vein were acquired, analyzed, and post-processed using VR to determine the anatomical rela-tionship between vessels and tumors. Pulmonary lobectomy followed. Cases in the control group underwent pulmonary lobectomy with-out guidance by chest MSCTA. Operation times and amounts of operative blood loss were compared between the two groups. Results:Significant differences between groups in terms of operation time (study group vs. control group, 199±55.7 vs. 231.5±51.2(min);P=0.02) and amount of operative blood loss (study group vs. control group, 318.33±99.6 vs. 431.7±89.5(mL), P<0.01) were observed. Val-ues of operation time and amount of contrast agents in the study group were consistently lower than those in the control group. Conclu-sion:Chest MSCTA can shorten the operation time and reduce the amount of operative blood loss during pulmonary lobectomy. Thus, the technique has significant clinical value.

Humans ; Genetic Markers ; Family ; DNA Fingerprinting ; Microsatellite Repeats/genetics*

Adolescent ; Cord Blood Stem Cell Transplantation ; adverse effects ; Humans ; Hypertensive Encephalopathy ; etiology ; Male ; Transplantation, Homologous

BACKGROUND: Presently, acute rejection following renal transplantation remains a risk factor for chronic rejection and graft function injury, How to non-invasive, rapid and exact diagnosis and prompt treatment is important. OBJECTIVE: To investigate early diagnosis and post-treatment expression of urine monocyte chemoattractant protein-1 (MCP-1) in the acute rejection after renal transplantation, through detecting the association of the urine MCP-1 variation according to some cases of nephridial tissue biopsy. METHODS: We selected 62 chronic renal failure patients who received renal homotransplantations in the Department of Renal Transplantation of Zhengzhou People's Hospital from October 2008 to February 2009. The stable renal function group contained 42 patients with stable renal function following renal transplantation. Acute rejection group contained 20 patients with acute rejection following renal transplantation. We chose 10 patients who examined no abnormalities in the Medical Examination Center of Zhengzhou People's Hospital to detect their urine sample as control group. All patients following renal transplantation underwent conventional immunosuppression. In addition, patients in the acute rejection group were treated with antilymphocyte globulin or methylprednisolone reinforced impact therapy. MCP-1 mass concentration changes were measured by double antibodies sandwich enzyme linked immurosorbent assay. RESULTS AND CONCLUSION: Compared with control group, no significant change was determined in urine MCP-1 mass concentration in the stable renal function group (P > 0.05). The urine MCP-1 mass concentration was significantly increased in the acute rejection group (P< 0.01). Compared with pretreatment, urine MCP-1 mass concentration was significantly decreased following treatment in 20 patients from the acute rejection group (P < 0.01). Of them, 17 cases had relieved clinical symptom, and normal auxiliary examination, and their urine MCP-1 mass concentration was close to the control group; 3 cases were inefficient, whose urine MCP-1 mass concentration was greater than the control group. Eight cases received nephridial tissue biopsy, and kidney pathology demonstrated acute rejection of transplanted kidney, which was similar to urine MCP-1 mass concentration in the acute rejection group prior to treatment (P > 0.05). These indicated that the level of MCP-1 in urine can non-invasively diagnose acute rejection following renal transplantation in an early phase, and monitor therapeutic efficacy. This may be associated with renal pathological injury during acute rejection following renal transplantation.

ObjectiveTo investigate the clinical effect and treatment experience of complicated acetabular fractures treated with open reduction with combined ilio-inguinal and Kocher-Langenbeck (K-L) approaches.MethodsSixty-six patients with complicated acetabular fractures were treated surgically with combined ilio-inguinal and K-L approaches from February 2004 to December 2009.Among them,45 cases were followed up for 8-45 months,with the average 26 months.ResultsOperation time was 1.4-5.7 h,with the average of 2.8 h.Intraoperative blood loss was 530-2300 ml,with the average of 1250 ml.According to Matta's score system,the excellent and good rate was 86.7％.According to modified Merle d' Aubigne and Postel score system,the excellent and good rate of function of hip was 86.7％.According to Brooker heterotopic ossification standard assessment system:Ⅰ degrees in 6,Ⅱ degrees in 3.According to Letournel and Judet clinical classification system,postoperative traumatic arthritis were 6 patients.Among them,3 patients with Ⅲ- Ⅴ period with symptoms of serious hip pain and joint activities obstacles were treated with total hip replacement secondly.Six cases of sciatic nerve injury and 9 cases of lateral femoral cutaneous nerve damage were recovered gradually after six months to a year.All incisions healed primarily.All got bony union,the healing time was 8 to 16 weeks,with the average of 10.4 weeks.None was complicated with femoral head necrosis.ConclusionFor the patients with complicated acetabular fractures,open reduction with combined ilio-inguinal and K-L approaches can get clinical advantages of revealed fully,fracture restoration convenient,fixed tightly,fewer complications and satisfactory result.

Objective To explore sub-clinical items in evaluating the prognosis of epileptic patients,the study on differences of regional cerebral blood flow (rCBF) in both effective treated and incomplete-controlled patients with idiopathic generalized tonic clonic seizure (GTCS) was carried out.Methods Interictal rCBF measurements using 99m Tc-ethyl cysteinates dimmer (ECD) SPECT was performed on 29 effective treated idiopathic GTCS patients and 12 incomplete controlled idiopathic GTCS patients. The rCBF distribution was semi-quantitatively analyzed by regions of interest (ROIs) comparing with abnormal rate of interictal hypoperfusion rCBF,clinical seizure time and EEG.Results ROI analysis showed that rCBF decreased in basal ganglia and thalamus of incomplete controlled patients with idiopathic GTCS compared to that of effective treated ones′ significantly ( P

Objective To investigate the potential influencing factors which possibly effected the gut barrier function.The effort was made to establish a clinical evaluation system of gut barrier dysfunc- tion.Methods Fifty-three critically ill patients with an APACHEⅡscore of 8 or more and 27 patient which APACHEⅡscore was 6 or less were recruited.Plasma was reserved for measurement of endo- toxin,tumor necrosis factor-?,diamine oxidase,D-lactic acid and high sensitive C reactive protein,uri- nary excretion of lactulose and mannitol and the urinary content of intestinal fatty acid binding protein (IFABP) were determined as well.Analyses was achieved by univariate,multivariate analysis and receiver operating characteristic curve.Results In the logistic regression models,gut barrier was affect- ed by many factors.The ratio of lactulose and mannitol in urine,the urinary content of IFABP of 24 hours and endotoxin level of plasma were identified as the most intimate factors which could associate with gut barrier function.The optimal operating point of plasma endotoxin,ratio of urinary lactulose and mannitol and content of urinary IFABP of 24 hours were 0.145,17 ng and 0,055 EU/ml respectively based on the results of receiver operating characteristic curve,the sensitivity and specificity were 84.5% vs 88%,78% vs 88% and 78% vs 78%.The doubtable value interval of urinary ratio of lactulose and mannitol was limited as 0.178 to 0.082.Conclusion Gut barrier dysfunction should be suspected when critically ill patients presented eertains gastrointestinal symptoms and had the proofs of increasing intesti- nal permeability,hypoperfusion of gut and higher level of plasma endotoxin.

Objective To investigate the sensitizing effects and the mechanisms of selective cyclooxygenase-2(COX-2)inhibitor celecoxib on radiotherapy of pancreatic cancer.Methods Radiosen- sitization of celecoxib in pancreatic cancer cell SW1990 in vivo and in vitro were investigated by colony forming assay and xenograft tumor model.Expressions of proliferating cell nuclear antigen(PCNA)and Cyelin D1 were assessed by Western Blot.Effect on apoptosis was studied by TUNEL.Expression of bcl-2 and bax was assayed by RT-PCR.Expression and secretion of matrix metalloproteinases(MMPs) and tissue inhibitors of metalloproteinases(TIMPs)were assessed by RT-PCR and zymography.Results Celecoxib enhanced the effect of radiotherapy on pancreatic cancer in vitro and in vivo.TUNEL demonstrated a significant increase of apoptotic cells in vitro after treatment with celecoxib alone or com bined with radiation,but no change after radiation.Expression of bcl-2 was decreased by celecoxib;radi- ation induced the expression of bcl-2;combination of celecoxib and radiation significantly suppressed the expression of bcl-2.In vitro,angiogenesis and cell invasion potential of pancreatic cancer cells were in- hibited by celecoxib,and celecoxib combined with radiation,but without significant change in radiation group compared with the control group.Expression and secretion of MMP-2 and MMP-9 were closely related to the changes in angiogenesis and cell invasion potential,while the expressions of TIMP-1 and TIMP-2 did not alter significantly in all groups.Conclusions The selective eyclooxygenase 2 inhibitor celecoxib potently enhances the effect of radiation on the treatment of pancreatic cancer. Induction of apoptosis,inhibition of angiogenesis and invasion are involved in the mechanism of cele- coxib treatment.

Objective To investigate the effects of heme oxygenase-1 (HO-1) protein transduction mediated by cell penetrating peptide PEP-1 on intestinal injury in a rat model of sepsis induced by cecal ligation and puncture (CLP).Methods Twenty-four healthy male Sprague-Dawley rats,aged 7-9 weeks,weighing 210-260 g,were randomly divided into 4 groups (n =6 each) using a random number table:sham operation group (group S),group CLP,low-dose fusion protein PEP-1-HO-1 + CLP group (group P1) and high-dose fusion protein PEP-1-HO-1 + CLP group (group P2).Fusion protein PEP-1-HO-1 0.3 mg was administrated via the left iliac vein at 1 h before CLP and 5 h after CLP in group P1.Fusion protein PEP-1-HO-1 0.6 mg was administrated via the left iliac vein at 1 h before CLP and 5 h after CLP in group P2.The equal volume of normal saline was given instead of PEP-1-HO-1 in the other groups.The animals underwent laparotomy,but the caecum was not ligated or punctured in group S.Blood samples were collected at 12 h after CLP from the right common carotid artery for measurement of serum TNF-α and IL-6 levels.The rats were then sacrificed and intestines were removed for microscopic examination and for determination of malondialdehyde (MDA) content and superoxide dismutase (SOD) activity in intestinal tissues.Results Compared with group S,the serum TNF-α and IL-6 levels,and MDA content in intestinal tissues were significantly increased,while SOD activity in intestinal tissues was decreased in CLP,P1 and P2 groups.Compared with group CLP,the serum TNF-α and IL-6 levels,and MDA content in intestinal were significantly decreased,while SOD activity in intestinal tissues was increased in P1 and P2 groups.Compared with group P1,the serum TNF-α and IL-6 levels,and MDA content in intestinal tissues were significantly decreased,while SOD activity in intestinal tissues was increased in group P2.The pathological changes of intestines were significantly mitigated in P1 and P2 groups as compared with group CLP.Conclusion HO-1 protein transduction attenuates intestinal injury induced by sepsis in rats,and the mechanism is related to inhibition of systemic inflammatory responses and lipid peroxidation in intestinal tissues.