Of the 250 cases of blunt abdominal trauma,15 cases of pancreatic lesions were complicatedwhich include 3 cases lacerated on the head of pan-creas, 5 on the body, 6 on the tail and one con-tused. The pancreatic bed drainage was performedfor one case, repair for 8 cases and pancreatic tailresection for 6 cases, In author's experiences, theroutinely inspecting the pancreas was carried outintra operatively, with blunt epigastric trauma, es-pecially the light red hemotoliquid was found bypericentesis. Operative method was classified frompancreatic bed drainage, repair and resection in ac-cordance with severity of the trauma, For prevent-ing the pancreatic juice fistula, the main pancreaticduct must try its best to be ligated. If the traumais on the head, a common bile duct and duodenumdecompression must be done.

Object To study the separation effect of three macoroporous resins for lycopene and ? carotene, in order to optimize the suitable one. Methods The performances of adsorption and desorption for lycopene and ? carotene with three macroporous resins D4020, X 5 and AB 8 were compared, and adsorption dynamics process of resins was studied. Results The adsorptive capacities of X 5 resin for lycopene and ? carotene are the most, they are 7 44 and 11 2 mg/g, respectively. Desorption ratio of X 5 resin is the highest. Conclusion X 5 resin is an ideal adsorbent for lycopene and ? carotene extraction.

AIM Objective By comparing E.coli's resistance to antibiotics and Chinese medical herbs before and after incubated in LB containing Neomycin or Chinese medical herbs, we try to understand the difference in their mechanism of resistance. METHODS We incubated E.coli cells under the culturing media with low concentration of Neomycin and Chinese medicine herbs respectively; lately, the culturing process were continued under the media with no Neomycin or Chinese medicine herbs. We tested the minimal inhibitory concentrations(MIC)of Neomycin(Kanamycin, Gentamicin, Tetracyclin etc) and Chinese medical herbs to culture cells. Result The experimental data indicated that increased resistance of population cells in the broth including Neomycin happened easily, as well as multi resistance simultaneously. As for the Chinese medical herbs, the case is different. After growing in the LB containing one of Huang Lian (rhizoma coptidis), Berberine or San-Huang-Tang of low concentrations, population cells did not increase their resistance either to antibiotics or to Chinese medical herbs. Removing the pressure of Neomycin, E.coli population cells resistance came back to the initial level. CONCLUSION The increased antibiotic resistance of population cells is unstable, and alternative using of different antibiotics maybe contribute to the alleviation of antibiotics resistance.

Objective To explore the most important risk factors in metabolic syndrome(MS) components.Methods Ninety-four individuals were classified into MS and non-MS group according to the diagnostic criteria for MS proposed by Chinese Diabetes Society(CDS) revised in 2006 or International Diabetes Federal(IDF) in 2005.Age,waist circumference(WC),body mass index(BMI),fasting plasma glucose,lipid profile,blood pressure and blood cell counts in two groups were compared.Partial least squares discriminant analysis(PLSDA) was carried out to determine the most important components of MS.Results Patients with MS diagnosed by CDS or IDF criteria have significantly older age,higher BMI,WC,blood pressure,fasting plasma glucose,triglycerides,insulin levels,insulin resistance index,high sensitivity CRP and fibrinogen levels compared with non-MS group.PLSDA analysis shows WC,BMI,blood pressure and aging are most important components of MS.Conclusion Obesity,hypertension and aging are three most important components of MS with obesity is the utmost among them.

Objective To observe the protective effect of bioimpedance spectroscopy guided ultrahltration on residual renal function in new hemodialysis patients.Methods Patients with end-stage renal disease recruited from January 2015 to June 2016,were randomly divided into experimental group and control group.And all the patients were followed up for 3 months.The ultrafiltration was guided by the bioimpedance spectroscopy analysis in the experimental group,while the ultrafiltration was based on the edema,blood pressure,symptoms of low blood pressure and the increase of weight during the hemodialysis interphase in the control group.The difference of residual renal function,24 hours urine volume and the incidence rate of adverse events between the two groups were collected.Results Compared with the control group,the urine volume(932.58 ± 230.16 ml vs 584.45 ± 137.76 ml,t =7.226,P ＜ 0.001) and residual renal function (RRF) (4.55 ± 0.90 ml/min vs 3.08 ±0.68 ml/min,t =7.300,P ＜0.001)in the experimental group were higher.The drop of RRF(3.14 ±2.05 ml/min vs 4.40 ±2.09 ml/min,t =-2.384,P =0.020) and urinary volume (452.58 ±456.96 ml vs 877.45 ± 452.45 ml,t =-3.679,P =0.001) were lower in the experimental group.While there was no significant difference in the incidence of adverse events between the two groups (t =2.081,P =0.084).Conclusions It is helpful for slowing down the decline of residual renal function by using the bioimpedance spectroscopy guided ultrafiltration.

OBJECTIVE To establish an in vitro test method and to evaluate the genotoxicity of chemicals using primary cultured mouse hepatocytes and the changes in phosphorylated histone H2AX(γH2AX)expression levels to provide a more reliable marker of the identification of genotoxicity. METHODS Hepatocytes were isolated from BALB/c mice by an improved two-step collagenase diges?tion method and then cultured in sandwich configuration. The primary cultured hepatocytes were treat?ed with various concentrations of four known genotoxic agents bleomycin(BLM),benzo(a)pyrene〔B (a)p〕,styrene and styrene-7,8-oxide(SO)within the range of 40 μmol · L-1 and two non-genotoxic agents azathioprine(Aza)and ciclosporin A(CsA)at different time points within 24 h. The cytotoxicity induced by these toxicants was assessed by CCK-8 assay. Then,the changes in γH2AX expression levels in treated cells were determined by flow cytometry. RESULTS The four genotoxic agents could be detected and two non-genotoxic agents could not be detected by this method. The γH2AX expression level was the highest when hepatocytes were exposed to BLM and SO for 3 h,or B(a)p and styrene for 6 h(P<0.01). The production of γH2AX was 25.67,18.36,12.43 and 14.25 for the four types of genotoxic agents,respectively,and was approximately 19,13,9 and 11 times that of the vehicle control group(P<0.01)at the optimum time point and concentration. There was a significant positive corre?lation between the indicated concentrations of genotoxic chemicals and γH2AX expression levels(P<0.01). In addition,the production ofγH2AX indicated no marked increase in two non-genotoxic agents such as Aza and CsA in comparison with the control group. CONCLUSION This test method can effec?tively distinguish genotoxic agents from non-genotoxic agents,and direct genotoxic agents from indirect genotoxic agents in the absence of S9. γH2AX might be a reliable marker for the identification of the potential genotoxicity of chemicals.

Obstuctive sleep apnea-hypopnea syndrome(OSAHS) is a kind of disease that seriously endangers children′s health, which can disrupt children′s normal ventilation and sleep structure.Untreated OSAHS in children can cause damage to multiple systems, including cardiovascular, metabolic, endocrine and neurocognitive systems and even to death.Although polysomnography is the gold standard for the diagnosis of OSAHS in children, it is thought to be costly, labor-intensive, uncomfortable and the limitation of medical conditions in some areas, many patients can not obtain timely diagnosis.Therefore, it is necessary to find a simple and effective method for early screening of OSAHS in children.

Objective To determine the feasibility of OZAKI procedure aortic valve neo-cuspidization(AVneo) for the treatment of aortic valve disease in our institution.Methods Twelve consecutive patients from November 2015 to October 2016 received AVneo in our single center are retrospected.Their mean age was(41.3 ± 16.9) years old.There were 11 males and 3 females.3 patients had aortic stenosis and 11 patients had aortic insufficiency.Autologous pericardium was used to reconstruct 3 aortic leaflets independently.The distance between each commissure was measured by a specific sizer to decide the size of each leaflet.Suturing the pericardial leaflets onto each aortic annulus.Results There was no perioperative mortality.No operations converted to prosthetic valve replacement.1 patient experienced IABP therepy for 2 days,for ventricular tachycardia repeatedly happened when cardiac rebeating intraoperation.Echocardiography one week after surgery showed an average maximum flow velocity of aortic valve of(162.9 ± 34.2) cm/s,average peak pressure gradient of(11.1 ± 4.9) mmHg (1 mmHg =0.133 kPa).Except 1 patient had moderate regurgitation after surgery,the rest of 13 patients showed less than mild aortic regurgitation.Conclusion OZAKI procedure AVneo provides good short-term results in patients with various aortic valve disease.

Objective:To summarize the construction of a technics system of aortic valve repair in adult patients with aortic regurgitation(AR).Methods:From March 2013 to May 2020, aortic valve repair was performed in 79 patients. In which 43 cases underwent simple technics such as subcommissural annuloplasty, leaflet plication etc. Cases done before May, 2018 were defined as A group, yet the other 36 cases underwent a routine repair technics system including annuloplasty, sinusplasty, cuspidplasty and sinotubularplasty after then as B group. The general data and the operation procedure, also the follow-up were analyzed.Results:In group A, there were 2 cases with simple aortic valve repair and 41 cases with other intracardiac operations. In group B, 23 patients had aortic valve repair alone and 13 patients had other intracardiac operations. Group A mostly adopts the technologies of subjunctional involution and ridge suspension. In group B, flap ring molding, flap leaf molding, sinus tube joint molding and other technologies were used. Postoperative reflux was reduced to moderate or mild in most patients in group A. In group B, postoperative reflux was reduced to mild in most patients. There were 7 cases of severe reflux in group A, and 2 cases of severe reflux were worse after repair than before surgery. In group B, 8 patients had no effective repair, and 3 patients continued to have satisfactory repair after the second turnaround. Aortic regurgitation at 1 year(or the last echocardiographic follow-up) after surgery: 15 patients in group A were mild, 17 were moderate, and 4 were severe; In group B, 2 patients underwent revalve replacement within 1 year, and the remaining 29 patients were moderate and mild, 20 cases were moderate, 7 cases were moderate, and 2 cases were severe.Conclusion:In some adult moderate and severe AR cases, a routine combined repair system can be applied to increase success rate of repair, and shows a good short and mid-term result.

Objective:To investigate the value of pulse oxygen saturation (SpO 2) monitoring in predicting children with moderate-to-severe obstructive sleep apnea (OSA). Methods:It was a retrospective study involving 341 children with snoring during nighttime sleep who had visited the Children′s Hospital of Soochow University from June 2017 to November 2020 and monitored for polysomnography (PSG) and SpO 2.The SpO 2 parameters mainly included oxygen desaturation index (ODI), oxygen desaturation index ≥3% (ODI3), oxygen desaturation index ≥4% (ODI4), mean pulse blood oxygen saturation (MSpO 2), lowest pulse blood oxygen saturation (LSpO 2), cumulative time spent with blood oxygen saturation below 95%, 92% and 90%(T95, T92 and T90). According to obstructive sleep apnea hypopnea index (OAHI), patients were divided into the snoring and mild OSA group (OAHI≤5 times/h) and moderate-to-severe OSA group (OAHI>5 times/h). Differences in SpO 2 parameters were compared between groups using the Chi- square test and Mann- Whitney U test. Spearman correlation analysis was used to analyze the correlation between SpO 2 parameters and OAHI in all children.The SpO 2 parameters were included in the Logistic regression model.Receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of SpO 2 parameters on moderate-to-severe OSA. Results:A total of 341 patients were recruited, including 206 male and 135 female patients with the mean age, body mass index (BMI) and OAHI of 6.0 (4.0, 7.5) years, 16.2 (15.1, 18.0) kg/m 2 and 0.6 (0.1, 3.0) times /h, respectively.There were 283(83.0%) and 58 (17.0%) patients in the snoring and mild OSA group and moderate-to-severe OSA group.The ODI3[0.7 (0.3, 1.4) times/h vs.7.7 (4.4, 12.8) times/h], ODI4[0.4 (0.1, 0.8) times/h vs.5.3 (2.7, 9.1) times/h], T95[1.4 (0.3, 5.3) min vs.13.7 (7.0, 33.5) min], T92[0.1 (0, 0.5) min vs.1.8 (0.9, 6.0) min] and T90[0 (0, 0.1) min vs.0.6 (0.2, 2.2) min] were significantly lower in the snoring and mild OSA group than those of moderate-to-severe group, while LSpO 2[91.0 (89.0, 93.0)% vs.86.5 (82.0, 88.0)%] and MSpO 2[ 97.0 (97.0, 98.0)% vs.96.0 (96.0, 97.0)%] were significantly higher(all P<0.001). All SpO 2 parameters were significantly correlated with OAHI (all P<0.001), and the correlation coefficient between ODI3 and OAHI was 0.660.ODI3 was an independent predictor of moderate-to-severe OSA ( OR=3.117, 95% CI: 1.635-5.945, P=0.001). The area under the ROC curve of ODI3 in predicting the moderate-to-severe OSA was 0.957, and the cut-off value of 3.45 times/h and specificity of 95.4%.MSpO 2 was an independent predictor of moderate-to-severe OSA ( OR=2.917, 95% CI: 1.589-5.354, P=0.001). Conclusions:ODI3 can be used to predict the moderate-to-severe OSA in children.