OBJECTIVETo explore the value of ultrasono-portography using SonoVue in selective portal vein embolization (SPVE).

METHODSTwenty-eight patients with malignant liver tumors underwent percutaneous ultrasound-guided SPVE. The procedure was performed under color Doppler ultrasound guidance in 11 cases (conventional group) and under guidance with ultrasono-portography using SonoVue in 17 cases (contrast group). Contrast-enhanced CT was performed 2-4 weeks after SPVE to evaluate the effect of embolization.

RESULTSThe procedure of SPVE was aborted in 3 cases in which ultrasono-portography showed contraindications. Postoperative contrast-enhanced CT showed ectopic embolization in 2 cases in the conventional group, and none of the cases in the contrast group showed ectopic embolization.

CONCLUSIONUltrasono-portography using SonoVue can provide important assistance for SPVE.

Carcinoma, Hepatocellular ; pathology ; therapy ; Embolization, Therapeutic ; methods ; Female ; Humans ; Liver Neoplasms ; pathology ; therapy ; Male ; Middle Aged ; Portal Vein ; Portography ; methods ; Ultrasonography, Doppler, Color

Remdesivir-loaded liposomes for inhalation were prepared and the in vitro properties were evaluated. Firstly, preparation methods of remdesivir-loaded liposomes were screened, and single-factor experiments were conducted to optimize the prescription and preparation process. Then the physical property, deposition ratio and aerodynamic particle size distribution of remdesivir-loaded liposomes suspension for inhalation were comprehensively evaluated. As a result, the optimal liposomes were prepared by the thin-film dispersion method with pH 6.5 phosphate-buffered saline as the hydration medium. In the prescription, the ratio of drug to DPPC was 1∶20; the cholesterol accounted for 10% of total lipids; and 20% DSPE-mPEG 2000 was added as stabilizer.4% trehalose was added as lyoprotectant when lyophilizing to obtain ideal appearance, good stability and a small particle size change after reconstitution. Remdesivir-loaded liposomes were spherical with smooth surface and uniform particle size distribution under transmission electron microscope. In vitro release tests showed no significant change for release curves of remdesivir-loaded liposomes suspension before and after nebulization. Deposition experiments indicated that the fine particles fraction of liposomes was 51.4%, and the mass median aerodynamic diameter was less than 5 μm measured by next generation impactor. To sum up, remdesivir-loaded liposomes for inhalation with high encapsulation efficiency and stability can achieve a suitable particle size distribution to effectively deposit in the lung after nebulization, which provides a new approach for the treatment of COVID-19.

Objective To investigate the epidemiological and clinical characteristics of hand,foot and mouth diseases (HFMD) in Linyi area,which may provide insight for developing disease control therapy.Methods Make an observation table,then record and analyze the epidemiological and clinical characteristics of HFMD in Linyi area.The data was then descriptively analyzed.Results The highest peak of HFMD incidence was detected at May.Most of the patients were children less than 3 years old and there was a tendency of HFMD in boys and children living in rural and suburban areas.Clinical symptoms mainly included fever and skin rash.Severe patients can also have various complications.Laboratory test usually showed elevated leukocyte count and neutrophil percentage.The major pathogens causing severe HFMD cases were enterovirus 71 (EV71),accounting for 77.21％ of all cases.Conclusion HFMD of Linyi area showed varied epidemiological characteristics at different seasons,areas and population.Developing control therapy according to the specific epidemiological and clinical characteristics is essential for the management of HFMD in Linyi area.

OBJECTIVETo evaluate the impact of different techniques for gastrointestinal tract reconstruction on postoperative pancreatic β-cell function in patients with type 2 diabetes mellitus (T2DM).

METHODSTwenty-three patients with gastric cancer and T2DM were studied. Techniques for reconstruction included Billroth I (n=13) and bypass procedures(Billroth II n=4 and Roux-en-Y anastomosis n=6). Pancreatic β-cell function was evaluated by oral glucose tolerance test (OGTT). Serum insulin was measured by electrochemiluminescence immunoassay and blood glucose by glucose oxidase method. HOMA-IR and HOMA-β were assessed.

RESULTST2DM remission rate was 90% (9/10) in the bypass group, and 23% (3/13) in Billroth I group (P<0.01). Glycosylated hemoglobin A1c and glycated hemoglobin HbA1 were improved significantly in patients after bypass procedures(P<0.05), but the difference in Billroth I group was not statistically significant (P>0.05). OGTT showed that fasting and post-glucose load plasma glucose at each time point were significantly lower in the bypass group compared to the Billroth I group. At 30 minutes and 60 minutes after glucose load, insulin levels and insulin release index were significantly higher in the bypass group compared to Billroth I( group, as were levels of HOMA-β and ΔI30/ΔG30 in the bypass group(P<0.05).

CONCLUSIONGastrointestinal bypass following gastrectomy may induce resolution of T2DM and improve β-cells function.

Aged ; Diabetes Mellitus, Type 2 ; complications ; physiopathology ; Female ; Gastrectomy ; Gastroenterostomy ; methods ; Humans ; Insulin-Secreting Cells ; physiology ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms ; complications ; surgery

Objective To analyze the prevalence characteristics and influence factors of Japanese encephalitis(JE) neutralizing antibody in healthy people.Methods Xinyang and Luoyang is the two cities in Henan Province.In 2010,healthy people of these two cities were selected by random sampling method to eight age groups:less than one year old,1 - 2 years old,3 - 4,5 - 6,7 - 14,15 - 19,20 - 59,and above 60 years old,their blood specimens were collected in May before JE infection and in November after JE infection,then followed with epidemiological investigation for JE neutralizing antibody by MCPENT.Results 519 healthy people were surveyed,1008 effective blood specimens were collected and tested.The JE neutralizing antibody positive rate was 59.52％ in men,and 67.39％ in male,these two rates had no statistical significance (x2=3.41,P ＞ 0.05 ).The JE neutralizing antibody was 58.66％ in May,and 61.20％ in November,these two rates had no statistical significance (x2 =0.68,P ＞ 0.05).The JE neutralizing antibody positive rate of 0 - 14 years old age group was 55.19％ in Xinyang,and 45.03％ in Luoyang,these two rates had no statistical significance(x2 =3.53,P ＞ 0.05 ).The JE neutralizing antibody positive rate of above 15 years old age group is 97.78％ in Xinyang,and 48.94％ in Luoyang,these two rates had statistical significance (x2 =55.42,P ＜ 0.05).The JE neutralizing antibody positive rate of JE vaccination was 56.85％,and 38.35 ％ in no JE vaccination,these two rates had statistical significance(x 2=10.88,P ＜ 0.05 ).Conclusion The JE neutralizing antibody positive rate was showing significant differences in people above 15 years old between Xinyang and Luoyang.The JE neutralizing antibody positive rate was showing significant differences between.JE vaccination and no vaccination.Xinyang and Luoyang City,recommended strengthening the 0 -14 year-olds immunized,and at the same time,exploring and paying attention to JE immunization strategy of people above 15 years old in Luoyang.

Objective To investigate the effect of continuous intraoperative insulin infusion on my-ocardial blood perfusion after cardiac surgery under cardiopulmonary bypass(CPB).Methods Forty-eight patients,21 males and 27 females,aged 55-80 years,BMI 18-28 kg/m2,ASA physical status Ⅱ-Ⅳ,who underwent elective cardiac surgery with CPB were selected and randomly divided into two groups:the insulin group(group I,n = 25)and the control group(group C,n = 23).The same anesthesia protocol was implemented in both groups.After induction of anesthesia,group Ⅰ received intravenously infusion of in-sulin 30 mU·kg-1·h-1,glucose 0.12 g·kg-1·h-1,and potassium chloride 0.06 mmol·kg-1·h-1,and group C received saline 10 ml/h,all of which were infused until the end of surgery.The targeted blood glucose range for both groups was set at 6.1-11.1 mmol/L.Transesophageal echocardiography(TEE)was performed 10 minutes after induction of general anesthesia(T2)and before the end of surgery(T6)to ex-amine the coronary sinus(CS)flow spectrum and diameter,pulmonary venous flow spectrum,and calculate CS net antegrade flow velocity time integral(VTI).Femoral mean arterial pressure(MAP),central venous pressure(CVP),stroke volume(SV),cardiac index(CI)and peripheral vascular resistance index(SVRI)were recorded at T2,2 minutes before CPB(T3),the end of CPB(T5),and T6.The concentra-tions of blood glucose and lactate 5 minutes before anesthesia induction(T1),T3,30 minutes after CPB(T4),T5,T6,6 hours after surgery(T7),12 hours after surgery(T8),and 24 hours after surgery(T9)were recorded.The levels of high-sensitivity C-reactive protein(hs-CRP),high-sensitivity troponin I(hs-TnI),and creatine kinase isoenzyme(CK-MB)were recorded 1 day preoperatively,1 and 2 days post-operatively.Results Compared with group C,in group I,CS net antegrade flow VTI and blood flow per minute were significantly increased(P<0.05),and pulmonary venous peak atrial reversal wave velocity(ARp)was significantly reduced at T6(P<0.05),SV and CI were significantly increased and SVRI was significantly decreased at T5 and T6(P<0.05),lactate concentration was significantly decreased at T7 and T8(P<0.05),hs-CRP and CKMB were significantly decreased 1 and 2 days postoperatively(P<0.05),hs-TnI was significantly reduced 2 days postoperatively(P<0.05).Conclusion Continuous insulin admin-istration during cardiac surgery with CPB while maintaining blood glucose at 6.1-11.1 mmol/L can enhance myocardial blood perfusion,mitigate postoperative inflammatory response,and reduce myocardial injury.

Objective To observe the clinical efficacy of TCM foot bath in adjuvant treatment for early diabetic lower-extremity peripheral arterial disease (LEPAD). Methods Totally 90 cases with early diabetic LEPAD were divided into treatment group and control group by random number table method, with 45 cases in each group. Control group was given routine treatment, including health education, diet control, proper exercise, control of blood sugar, blood pressure and blood lipids, nutritional nerves, dilation of blood vessels. On the basis of control group, the treatment group was given TCM foot bath, soaking the lower limbs for 30 minutes each time, once a day, for 12 weeks. The clinical efficacy of the two groups was evaluated. The TCM syndrome score, maximum painless walking distance, temperature of the toe skin, diameter of the lower extremity arterial blood vessels, lower extremity arterial blood flow, ankle brachial index (ABI), blood pressure (BP), FBG, HbA1c, serum adiponectin, IL-6 and TNF-α were detected. The blood routine, liver and kidney function were detected and adverse reactions were recorded. Results The total effective rate was 82.22% (37/45) in the treatment group and 68.89% (31/45) in the control group. The treatment group was significantly better than the control group (Z=-2.099, P=0.036). Compared with before treatment, the levels of TCM syndromes, BP, FBG, HbA1c, serum IL-6 and TNF-α were significantly lower in both groups after treatment (P<0.05); serum adiponectin level increased after treatment (P<0.05); the maximum painless walking distance, the temperature of the toe skin, the diameter of the lower extremity arterial blood vessels, the lower extremity arterial blood flow and ABI were significantly improved. Compared with the control group, the scores of TCM syndromes in the treatment group were significantly lower (P<0.05); the levels of IL-6 and TNF-α in the treatment group were significantly lower than those in the control group (P<0.05); the maximum painless walking distance, the temperature of the toe skin, the diameter of the lower extremity arterial vessels, the lower extremity arterial blood flow and ABI, serum adiponectin level in the treatment group were significantly higher than those of the control group (P<0.05). Conclusion TCM foot bath in adjuvant treatment for early diabetic LEPAD is with obvious efficacy, and the mechanism may be related to improving the level of serum inflammatory cytokines to inhibit the inflammatory injury of blood vessels.