0.05),but the mortality of the patients undergoing anatomical resection was higher than that of the patients undergoing resection debridement(? 2=4.85,P

Objective To explore the surgical alternatives to severe liver injuries. Methods The data of 86 cases with severe liver injury treated surgically from January 1989 to December 2001 were summarized. There were 43 cases with grade Ⅲ injury, 32 with grade Ⅳ and 11 with grade Ⅴ. Eleven cases complicated by injuries on cardinal vein and posthepatic vein were all treated surgically. Results Of all, 66 cases (76.7%) were cured and 20 (23.3%) died. The post operative complication occurred in 23 cases (26.7%). Conclusions Correct surgical procedure for severe liver injury is crucial for a better curative effect. It is safe and effective to ligate one or two hepatic veins when the liver trauma is complicated by hepatic vein injuries.

Objective To explore the management methods for liver injury combined with posthepatic vein injuries in order to make an improvement in corresponding treatment. Methods Twenty-three cases with liver injury combined with posthepatic vein injuries were treated with the following 5 ways: repairing the hepatic vascular blockage step-by-step, pressing directly to exhibit the injured vessels for repair, ligating the injured hepatic veins, suturing the hepatic tissues and packing with gauze. Results Of all, 18 cases (78.3%) were cured and 5 (21.7%) died. Conclusions Rational preoperative emergent resuscitation and correct complex intraoperative management are key to the liver injury combined with posthepatic vein injuries.

Objective To study the characteristics and treatments of occlusive abdominal injuries during pregnancy. Methods The clinical data of 37 cases with occlusive abdominal injuries admitted in hospital from June 1993 to June 2003 were collected for study. Results All 37 cases received operative treatment, of which two cases complicated by enterorrhexis in the early pregnancy and one by retroperitoneal hematoma were managed using laparoscope. Laparotomy was performed in other 34 cases, of which eight received caesaren section because of placental abruption and enlarged uterus that impeded the management for intraabdominal organs. Of all, 33 cases (33/37,89%) were cured and four (4/37, 11%) died. The postoperative incidence of complications was 16% (6/37). The complications included abdominal cavity infection in two cases (5%), pulmonary infection in three (8%) and multiple organ failure in one (3%). Conclusion Besides obstetrics' diseases, we must keep alert about the injury of abdominal organs during the management of trauma. Accurate diagnosis and timely treatment will win time to save the lives of mother and infant.

Objective To evaluate the clinical efficacy of transcatheter arterial chemoembolization (TOCE) and percutaneous absolute ethanol injection (APEI) in moderate or advanced liver cancer.Method During May,1993～Aug,1999, 137 patients with unresectable advanced liver cancer were retrospectively studied. 85 cases only received TOCE, 52 cases were treated by TOCE+APEI by B-US guidance.Results The effect in TOCE+APEI group was significant better than that in only TOCE group,the half year, 1-year,2-year and 3-year survival rates of the TOCE+APEI group were 86 54%,67 31%,43 55% and 21 77%,while those of the TOCE group were 65 89%,47 92%,22 12% and 1 48% respectively. There was significant difference between the two groups in survival rate(P

Objective To explore the effect of hepatectomy or cholangiolithotomy on patients with hepatocholangic stones. Methods The clinical data of surgical treatment of 316 patients with hepatocholangic stones combined with bile duct stricture was retrospectively analyzed. The patients were divided into two groups:172 patients chiefly underwent hepatectomy,and the other 144 patients chiefly underwent cholangiolithotomy. Results The ratio of residual stones and reoperation in the hepatectomy group was significantly lower than those in the cholangiolithotomy group (P

With the extensive application of highly sensitive genetic techniques in the field of prenatal diagnosis, prenatal chromosomal mosaicisms including true fetal mosaicisms and confined placental mosaicisms are frequently identified in clinical settings, and the diagnostic criteria and principle of genetic counseling and clinical management for such cases may vary significantly among healthcare centers across the country. This not only has brought challenges to laboratory technician, genetic counselor and fetal medicine doctor, but can also cause confusion and anxiety of the pregnant woman and their family members. In this regard, we have formulated a consensus over the prenatal diagnosis and genetic counseling for chromosomal mosaicisms with the aim to promote more accurate and rational evaluation for fetal chromosomal mosaicisms in prenatal clinics.
Consensus ; Female ; Genetic Counseling ; Humans ; Mosaicism ; Placenta ; Pregnancy ; Prenatal Diagnosis/methods*

To begin with, we constructed cfp10-esat6 fusion gene and its prokaryotic expression vector and had it express in E. coli. By GeneSOEing techniques, a fusion gene was constructed by splicing cfpl0 gene and esat6 gene, and then was cloned into pGEX-4T-1 plasmid. Secondly, we constructed the prokaryotic expression recombinant plasmid pGcfp10-esat6. After identification with restriction enzyme analysis, PCR and nucleotide sequencing analysis, The E. coli BL21 containing the recombinant plasmid was induced by IPTG (Isopropy-beta-D-thiogalatoside). The fusion protein CFP10-ESAT6 with GST-tag about 42 kDa was expressed and purified with GST-fusion protein purification kit,The expression of cfp10-esat6 fusion gene was subsequently detected by SDS-polyacrylamine gel electrophoresis and Western-blot analysis. The sequence of cfp10 and esat6 in recombinant plasmid was consistent with that of GenBank report. The fusion protein existed in cytoplasm in soluble form and represented about 40% total bacterial protein of E. coil. The fusion protein was purified and the purity reached 90%. Its antigenicity was confirmed by Western-blotting. The prokaryotic expression vector (pGcfp1o-esat6) was constructed successfully, and the fusion protein CFP10-ESAT6 was obtained. This study provided an experimental basis for potential application of the recombinant CFP10-ESAT6 in the diagnosis of tuberculosis.
Antigens, Bacterial ; biosynthesis ; genetics ; Bacterial Proteins ; biosynthesis ; genetics ; Cloning, Molecular ; Escherichia coli ; genetics ; metabolism ; Mycobacterium tuberculosis ; genetics ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; isolation & purification

Based on single-cell sequencing of the hippocampi of 5x familiar Alzheimer's disease(5x FAD)and wild type mice at 2-,12-,and 24-month of age,we found an increased percentage of microglia in aging and Alzheimer's disease(AD)mice.Blood brain barrier injury may also have contributed to this increase.Immune regulation by microglia plays a major role in the progression of aging and AD,according to the functions of 41 intersecting differentially expressed genes in microglia.Signaling crosstalk between C-C motif chemokine ligand(CCL)and major histocompatibility complex-1 bridges intercellular communi-cation in the hippocampus during aging and AD.The amyloid precursor protein(APP)and colony stimulating factor(CSF)signals drive 5x FAD to deviate from aging track to AD occurrence among intercellular communication in hippocampus.Microglia are involved in the progression of aging and AD can be divided into 10 functional types.The strength of the interaction among microglial subtypes weakened with aging,and the CCL and CSF signaling pathways were the fundamental bridge of communication among microglial subtypes.

Objective: To evaluate the efficacy and safety of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in prophylaxis neutropenia after chemotherapy in patients with lymphoma. Methods: This was a multicenter, single arm, open, phase Ⅳ clinical trial. Included 410 patients with lymphoma received multiple cycles of chemotherapy and PEG-rhG-CSF was administrated as prophylactic. The primary endpoint was the incidence of Ⅲ/Ⅳ grade neutropenia and febrile neutropenia (FN) after each chemotherapy cycle. Meanwhile the rate of antibiotics application during the whole period of chemotherapy was observed. Results: ①Among the 410 patients, 8 cases (1.95%) were contrary to the selected criteria, 35 cases (8.54%) lost, 19 cases (4.63%) experienced adverse events, 12 cases (2.93%) were eligible for the termination criteria, 15 cases (3.66%) develpoed disease progression or recurrence, thus the rest 321 cases (78.29%) were into the Per Protocol Set. ②During the first to fourth treatment cycles, the incidences of grade Ⅳ neutropenia after prophylactic use of PEG-rhG-CSF were 19.14% (49/256) , 12.5% (32/256) , 12.18% (24/197) , 13.61% (20/147) , respectively. The incidences of FN were 3.52% (9/256) , 0.39% (1/256) , 2.54% (5/197) , 2.04% (3/147) , respectively. After secondary prophylactic use of PEG-rhG-CSF, the incidences of Ⅳ grade neutropenia decreased from 61.54% (40/65) in the screening cycle to 16.92% (11/65) , 18.46% (12/65) and 20.75% (11/53) in 1-3 cycles, respectively. The incidences of FN decreased from 16.92% (11/65) in the screening cycle to 1.54% (1/65) , 4.62% (3/65) , 3.77% (2/53) in 1-3 cycles, respectively. ③The proportion of patients who received antibiotic therapy during the whole period of chemotherapy was 34.39% (141/410) . ④The incidence of adverse events associated with PEG-rhG-CSF was 4.63% (19/410) . The most common adverse events were bone pain[3.90% (16/410) ], fatigue (0.49%) and fever (0.24%) . Conclusion During the chemotherapy in patients with lymphoma, the prophylactic use of PEG-rhG-CSF could effectively reduce the incidences of grade Ⅲ/Ⅳ neutropenia and FN, which ensures that patients with lymphoma receive standard-dose chemotherapy to improve its cure rate.