Objective To discuss the surgical treatment for huge hepatoblastoma in children,and the technique of hepatectomy without blockade of the blood supply to the remained liver lobes.Methods We reviewed 12 cases of huge hepatoblastorna who had been operated from July 2001 to January 2009 in our hospital.The mean age of the children was 3.2 years(range,11 months to 12 years).The diameter of the tumor was from 10 to 23 cm.3～7 cycles of chemotherapy was routinely administrated before operation.When the tumor reduced to a certain size that radical resection could be performed safely,regular hepatectomy was conducted.Hepatoblastoma resection without blocking the blood supply to the remained liver lobes was performed in every patient.Results The operations were successfully accomplished in all the 12 children.5 cases received right trihepatectomy (segment Ⅳ,Ⅴ～Ⅷ),4 cases received right hemihepatectomy(segment Ⅴ～Ⅷ),and the other 3 cases received Ⅳ,Ⅶ,Ⅷ segmentectomy,right Ⅴ,Ⅵ segmentectomy,and left hemihepatectomy respectively.The intraoperative hemodynamic parameters were stable,and there was no perioperative mortality.Postoperative chemotherapy wag routinely administrated.The follow-up period varied from 2 to 92 months.11 children survived and were disease free,among those 6 children have survived for more than 5 years.One child had brain and lung metastasis 5 months post operation,and died 7 months post operation. Conclusion Preoperative chemotherapy administrated to children with huge hepatoblastoma can reduce the tumor size and render tumor reseetable.Hepatoblastoma resection without blocking the blood supply to the remained liver lobes is a safe and feasible surgical technique.

Objective To investigate the effect of reserpine,an efflux pumps inhibitor,on the activities of fluoroquinolones (FQNs) against Enterococci,and the distribution of efflux pump genes emeA and its correlation with the resistance of Enterococci.To elucidate the relationship between FQN resistance in Enterococci and active efflux.Methods One hundred isolates of enterococci were identified by VITEK microbe automatic system.The antibacterial agent susceptibility tests were performed by the disc diffusion method (K-B) in accordance with the CLSI standards.The minimum inhibitory concentration (MIC) of each FQN was tested by the agar dilution method,and the MIC changes were detected after adding reserpine.The distribution of emeA in 100 isolates of Enterococci was determined by PCR.Thex2 test was used to compare the differences of statistical results.Results After reserpine was used,three-FQN resistance in Enterococci was reduced.Ciprofloxacin,gatifloxacin and levofloxacin resistance was reduced from 42％ (42/100) to 28％ (28/100),from 30％ (30/100) to 17％ (17/100),and from 33％ (33/100) to 23％ (23/100),respectively.The positive rate of emeA gene in 100 strains of Enterococci was 55％ (55/100).There were 45 positive strains(72.6％) in 62 E.faecalis and 10 positive strains (26.4％) in 38 E.faecium.The positive rate of emeA gene in the resistant strains against ciprofloxacin,gatifloxacin and levofloxacin was 73.8％ (31/42),76.7％ (23/30),75.8％ (25/33),respectively,and the positive rate of emeA gene in the susceptible strains against above 3 antibacterials were 41.4％ (24/58),45.7％ (32/70),44.8％ (30/67).Efflux pump genes emeA in resistant strains is higher than the sensitive strains,with the statistically significant difference(x2 =13.02,8.13 and 8.57,P ＜ 0.005).Conclusions Reserpine could inhibit the active efflux of in FON Enterococci and reduce the MIC for drug-resistant strains in vitro.Multidrug-resistant efflux pump gene emeA was relevant to antimicrobial drug resistance in Enterococci.

In the cultural construction of independent institute,there exist the contradiction between tradition and innovation,cultural conflicts between private enterprises and the university.Therefore,adhering to the people-centered concept,coordinating tradition and innovation,merging the advantages of university culture and private enterprises culture into a whole,cultivating the unique spiritual culture,harmonious system culture and unified material culture of independent institute,forming the distinctive “Institute Culture” with its own cultural tradition will provide reference for the theory and practice to enrich and improve the connotative development of independent institute.

Objective To explore the feasibility of using clinical whole body MR scanners to investigate the intravital visibility of central nervous system (CNS) lesions in rats of multiple sclerosis (MS). Methods Ten Lewis rats were injected with the peptide 35-55 of myelin oligodendrocyte glycoprotein to make the model of MS. On a Siemens Sonata 1.5T MR scanner equipped with a flexible surface coil, rats brain and spinal cord were examined using T2-weighted and T1-weighted imaging with slice thickness of 1-2 mm. On a Siemens Trio Tim 3.0T MR-scanner equipped with a quadrature wrist coil, rats were examined using T2WI, T1WI and Gd-DTPA enhanced T1WI 3-dimensional imaging with voxel size up to 0.06-0.08 mm~3. Rat brain and spinal cord images in multiple orientations were reconstituted with special software in workstation. Results T2WI and T1WI of the lesions in MS rat brain with high spatial and contrast resolution could be obtained with clinical 3.0T MR scanner, though the image resolution of spinal cord was relatively low. The resolution of 1.5T MR was lower than that of 3.0T. Plaques in CNS of MS rats presented as hyperintense areas on T2WI and hypointense areas on T1WI. Contrast enhancement was observed as hyperintense on T1WI. Conclusion High quality images of CNS lesions canbe obtained with clinical 3.0T MR-scanner in MS rat, which offers a noninvasive access for studying CNS diseases in the rats.

Day care is described in the paper in terms of its meaning and management.As to areas deserving attention given the initial success,the authors proposed to priortize medical insurance compensation policy,medical resource deployment,patient safety and follow-up for discharged patients.These efforts may further quality of care and patient satisfaction.

AIM: To investigate the effect of high concentration of chlorine gas(Cl 2) exposure on lung haemodynamic and respiratory function in intact and isolated perfused rabbit lungs (IPLs). METHODS: 8 intact and 10 IPLs were exposed to Cl 2 at high concentration(50?10 -4 )for 20 min, as measured group, 8 additional intact and 9 IPLs, which were similarly treated but not exposed to Cl 2, served as controls. The changes of lung weigh of IPL(△W)?pressure of pulmonary artery(Pa)and venous pressure(Pv)?airway pressure and tidal volume(TV) were continuously measured and recorded simultaneously. RESULTS: In IPL group: While the perfusing blood flow was kept constant (133.3 mL/min), and Pv did not change, following the exposure, the Pa increased slightly, then the lung weight were increased significantly and the TV decreased . Hematocrit of perfusate of EIPL and parameters of lung water increased also. In intact group : Pa increased slightly, respiratory rate accelerated immediately, and TV decreased. CONCLUSION:Although mean Pa increased continuously and slightly in both intact and IPL group following the exposure to high concentration of Cl 2, the primary cause of edema was most likely to alter pulmonary capillary permeability. The respiratory rate accelerated and TV decreased due to exposure to Cl 2 enhanced hypoxia of intact rabbits.

Objective To investigate the changes in intrapulmonary shunting during controlled hypotension induced by sodium nitroprusside(SNP)in patients undergoing naso-endoscopic operation.Methods Forty ASAⅠorⅡpatients of both sexes(23 male,17 female)aged 16-50 yrs weighing 50-75 kg undergoing naso-endoscopic operation under general anesthesia with muscle relaxation and mechanical ventilation were studied.Radial artery was cannulated for direct BP monitoring and blood sampling.Right internal jugular vein was cannulated and the catheter was advanced into right ventricle.Blood sample taken from right ventricle was used as mixed venous blood instead of blood from pulmonary artery.ECG,MAP,HR and P_(ET) CO_2 were continuously monitored during operation Cardiac output was monitored with noninvasive cardiac function monitor(NC-COM.)based on impedance principle.SNP infusion was started at the beginning of operation at 1-3?g?kg~(-1)?min~(-1) and was then adjusted.MAP was reduced by 30%-40% and maintained at this level until the end of operation.Blood samples were taken from artery and right ventricle simultaneously before SNP infusion(T_1,baseline)at 30 and 60 min of hypotension(T_2,T_3)and at 20 min after BP returned to the baseline level(T_4)for blood gas analysis.Qs/Qt was calculated.Results Qs/Qt was significantly increased during controlled hypotension at T_2 and T_3 as compared to the baseline value(P＜0.01)and returned to the baseline level at T_4.HR was increased and cardiac output and stroke volume was significantly reduced during hypotension as compared to the baseline value.Conclusion The intrapulmonary shunting is increased and the hemodynamics is depressed during SNP-induced controlled hypotension and they return rapidly to baseline level after SNP is discontinued.No hypoxemia develops during SNP- induced hypotension.

AIM: To explore the effects of processing on components group of Semen Raphani. METHODS: By comparing HPLC maps of Semen Raphani samples prepared with different methods and computing similarity,(analysis) the change law of the components group. RESULTS: The mechanism of inhibiting the enzyme by processing Semen Raphani was found and C3 was able to produce new compounds A209,B221. CONCLUSION: Processing Semen Raphani can change the components group through influencing the decoction process,eventually produce different clinical effects.

Biomarkers ; blood ; Biopsy, Needle ; utilization ; Hepatitis C ; complications ; Humans ; Liver ; pathology ; Liver Cirrhosis ; diagnosis ; pathology

Objective To observe the expression and mechanism of hypoxia-inducible factor-1α (HIF-1α) and p53 protein at the altitude of 5000 meter plateau hypoxia environment in rats,as well as the effect of Astragalus injection.Methods Sixty Sprague Dawley rats were randomly divided into the Astragalus injection intervention group and normal saline control group,30 rats in each group.Astragalus injection group rats were intraperitoneal injected of Astragalus injection (15 ml/kg) before 30 minutes into the plateau environment simulation cabin,normal saline group rats were intraperitoneal injected with the same volume of saline.30 minutes after injection,rats in each group were reared in the plateau experiment cabin which simulated altitude of 5000 m (oxygen partial pressure 11.3 kPa) for 2,6,8,12,24 hours,each time period of 6 rats.When get out,the rats were executed immediately and eyes were harvested.Retinal sections were studied by hematoxylin eosin stain,and immunohistochemical method for HIF-1α and p53 expression.Results For control rats,after 2 hours in the cabin,there was edema in retinal layers.HIF-1α and p53 were expressed mainly in the cytoplasm of retinal layers.When the periods in cabin extended,there was atrophy of retinal nerve fiber layer,swelling and degeneration of ganglion cells.The expression of HIF-1α and p53 was increased.Compared with the control group,the intervention group rat had similar but less severe retinal changes,and the expression of HIF-1α and p53 was significantly decreased (P ＜0.05).Conclusion Astragalus injection can reduce pathological retinal damage in rats at high altitude environment,and its mechanism may be associated with reduced HIF-1α,p53 expression.