Objective To improve the diagnosis and treatment of liver trauma. Methods We retrospectively analyzed different therapeutic means on liver trauma including 79 cases with operative treatment and 27 cases with nonoperative treatment. Results In nonoperative treatment group, 25 cases were cured, 2 cases died. In operative treatment group, 73 cases were cured, 6 cases died. Cure rate was 92.5%(98/106), mortality was 7.5%(8/106). 5 cases died of major blood vessels rupture, 3 cases died on multiple organ function failure. Postoperative complications included 3 cases of subphrenic infection, 10 cases of hepatic abscess, 8 cases of pleural hydrops, 7 cases of incisional infection. Conclutions Type I of liver trauma can be treated by nonoperation, type Ⅱ～Ⅳ of blunt liver trauma can be treated by nonoperation on the condition of intensive monitoring. Type Ⅱ～ Ⅵ of liver trauma should be operated on emergently in case of massive intraabdominal bleeding and combined organ injury.

Information of metabolic enzymes and transporters, physiological parameters of animals and demography of Chinese people were integrated to establish a digital liver model (DLM) based on metabolism and transporter and coded with VBA. Clearance and drug-drug interaction (DDI) of candidate drugs in animal and human could be predicted based on the pharmacokinetic data obtained from in vitro and in vivo experiments. Pravastatin and pitavastatin were selected as the samples to examine this model, where their clearance and their DDI with cyclosporine were predicted. The results showed that the predicted values of median parameters in same species were within twofold of observed values for 83.3% (5/6). The program's successful prediction in DDI tendency might indicate its application in optimizing the dosage regimen and reducing the risk of clinical trial.

Objective To explore the causes and risk factors of cerebral stroke in young adults.Method The clinical data of 392 young patients (≤45 years old) of cerebral stroke were analyzed retrospectively,and analyzed its causes and risk factors. Results The most common etiology in youth ischemic cerebral stroke was atherosclerosis (48.70%, 112/230), followed by cardiogenic cerebral embolism (13.04% ,30/230). The main cause in youth hemorrhagic cerebral stroke was hypertension (39.51% ,64/162), followed by intracranial aneurysm(14.81%,24/162) and cerebral vascular malformation(10.49%,17/162). The main risk factors for young patients with cerebral stroke were hypertension (40.31% ,158/392),smoking (36.22%, 142/392),drinking (33.93%, 133/392),prior stroke (13.78% ,54/392),hyperlipidemia (11.99% ,47/392), others were heart disease (9.69% ,38/392), family history of strokehistories (8.16%,32/392) and diabetes (5.36%,21/392) and so on. As far as 160 young patients and 110 young patients were detected separately homocysteine and anticardiolipin antibody, positive rates were 39.38%(63/160) and 3.64%(4/110) respectively. Conclusions The main etiological factor of ischemic cerebral stroke in young adults is atherosclerosis, cardiogenic cerebral embolism is followed. The main etiological factor of hemorrhagic cerebral stroke in young adults is hypertension, intracranial aneurysm and cerebral vascular malformation are followed. The order of risk factors for the young patients with cerebralstroke were hypertension, smoking,drinking, prior stroke, hyperlipidemia,heart disease, family history of stroke-histories, diabetes and hyperhomocysteinemia.

Objective To introduce the clinical experience and investigate the significance and safety of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy.Methods A retrospective analysis was performed on 275 patients who underwent thyroidectomy among which 135 patients were treated by capsular dissection technique and harmonic scalpel (harmonic scalpel group),the other 140 patients were treated by electric knife and traditional ligation (traditional group).The thyroidectomy operative time,intraoperative bleeding volume,postoperative drainage volume and surgical complications were compared between two groups.Results In harmonic scalpel group,the thyroidectomy operative time of total thyroidectomy and subtotal thyroidectomy was significantly shorter than that in traditional group [(50.0±6.9) min vs.(82.0± 14.4) min,(39.9±6.6) min vs.(73.1 ± 14.5) min](P＜0.01).The intraoperative bleeding volume of total thyroidectomy and subtotal thyroidectomy in harmonic scalpel group was significantly lower than that in traditional group [(18.7 ± 10.9) ml vs.(41.9 ± 15.6) ml,(17.7 ± 9.3) ml vs.(42.2 ± 14.6) ml] (P ＜ 0.01).The postoperative drainage volume of total thyroidectomy and subtotal thyroidectomy in harmonic scalpel group was significantly lower than that in traditional group [(40.7 ± 11.7) ml vs.(53.9 ± 17.5) ml,(42.7 ± 14.5) ml vs.(61.8 ±22.9) ml](P＜0.01).The rate of temporary hypoparathyroidism and temporary recurrent laryngeal nerve palsy had no significant difference between two groups (P ＞ 0.05).Conclusions Application of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy can significantly reduce thyroidectomy operative time,intraoperative bleeding volume,postoperative drainage volume and surgical complications.Harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy should be widely used.

OBJECTIVE: To construct a plant effective expression vector driven by a fruit specific promoter for the expression of hepatitis B virus surface antigen (HBsAg), to further improve the expression of exogenous gene in plant, and to prepare for the development of an effective anti-hepatitis vaccine. METHODS: Tomato fruit-specific promoters' gene 2A12 and E8 were respectively introduced to pBPFOmega7 to form pB2A12 and pBE8. The DNA fragment containing HBsAg-s gene from plasmid YEP-HBs was inserted respectively into pB2A12 and pBE8 to form pB2A12-HBs and pBE8-HBs. The fragment containing "p35S+2A12+Omega+HBsAg-s+Tnos" of the pB2A12-HBs was sub-cloned into plasmid pCAMBIA1301 to yield the reconstructed plant binary expression plasmid pCAM2A12-HBs, and the fragment containing "p35S+E8+Omega+HBsAg-s+Tnos" of the pBE8-HBs was sub-cloned into plasmid pCAMBIA1301 to yield the plasmid pCAME8-HBs. The inserted gene HBsAg and fruit-specific promoters in the reconstructed plant binary expression vectors were confirmed by sequencing. Then, pCAM2A12-HBs and pCAME8-HBs were directly introduced into Agrobacterium tumefaciens strain EHA105. RESULTS: Digestion with restriction enzymes proved that all recombinant vectors had the inserts with expected length of the target fragments, and the sequencing results were confirmed correct. CONCLUSION: In this study, plant expression vector containing HBsAg gene driven by fruit specific promoter and CaMV35s promoter was successfully constructed.

Objective To observe the effects of baicalin on forms of hepatic tissue, liver apoptosis, mRNA expressions of iNOS, NF-κB and protein expression of Caspase-3 in rats with ischemia reperfusion injury; To discuss its mechanism of action.Methods The rat models of liver ischemia reperfusion were performed according to the Pringle's method. Rats were randomly divided into sham-operation group, model group and baicalin group. Sham-operation group and model group were given normal saline for gavage, while baicalin group was given baicalin for gavage. Morphological characteristic was observed by HE staining. Hepatocyte apoptosis was determined by TUNEL. The mRNA expressions of iNOS and NF-κB were determined by RT-PCR. The protein expression of Caspase-3 was determined by Western blot.Results Compared with the sham-operation group, mRNA expressions of iNOS and NF-κB and the protein expression of Caspase-3 in the model group increased, as well as liver apoptosis rate (P<0.05,P<0.01); compared with the model group, mRNA expressions of iNOS and NF-κB and the protein expression of Caspase-3 in the baicalin group decreased, as well as liver apoptosis rate (P<0.05), and the hepatic lesion significantly improved in the baicalin group.Conclusion Baicalin can restrain Caspase-3 induced apoptosis by reducing the expressions of iNOS and NF-κB, with a purpose to realize the hepatoprotective effect for liver of rats with ischemia reperfusion injury.

BACKGROUND: As a kind of unwounded biomagnetism technique, magnetoencephalography (MEG) relfects immediate information of cerebral function by using magnetic source imaging through recording changes of magnetic field of neurocytes under different functional status.OBJECTIVE: To investigate the practicability of magnetoencephalography (MEG) imaging in localizing sensory-motor cortex for brain tumour surgery in 36 patients.DESIGN: Observational study.SETTING: Department of Neurosurgery, Guangdong Provincial Hospital of Traditional Chinese Medicine.PARTICTPANTS: From Janury 2003 to April 2006, 36 patients (17 male and 19 female) with brain tumors selected from Deparment of Neurosurgery, Guangdong 999 Brain Hospital underwent surgery with MEG-guided neuronavigation in the region of the sensory and motor cortex. Ages of the patients ranged from 13 to 70 years. Among the 36 patients, 14 with gliomas (including 5 highly malignant gliomas), 19 with meningomas, 1 with spongy angioma and 2 with adenocarcinoma (due to the metastasis of brain tumor). All patients and relatives provided the confirmed consent and the experiment provided by the local ethics committee.METHODS: A 148-channel biomagnetometer (4-D Neuroimaging, USA) was used to determine motor and/or senory cortex with sampling rate 678.17 Hz, high-pass filter 1.0 Hz and bandwith 200 Hz. MRI images were acquired using a Philips Gyroscan Intera 1.5T MR tomography. And then, the functional maps were transfered to the neuronavigation system for the treatment of brain tumor. All patietns followed up by further consultation and telephone call in 2-26 months after operation.MAIN OUTCOME MEASURES : Operative outcome and prognosis.RESULTS: MEG demonstrated that the tumor lesion changed the sensory-motor cortex in various degrees for the 36 patients. Brain tumors were resected completely in 34 cases. At 2-26 months after surgery, neurological deficits fully recovered in 19 cases, unchanged in 15 cases and deteriorated in 2 cases.CONCLUSION: MEG was found to be practical and useful in localizing sensory-motor cortex and brain tumor. It is a valuable non-invasive method for presurgical planning in the treatment of brain tumors.

Objective We characterized the clinical features of sporadic Creutzfeldt-Jakob disease(sCJD)in or?der to diagnose it at the early stage. Methods Seventeen patients with sCJD were enrolled in the study. The clinical data, symptoms at the early stage, result of auxiliary examinations and survival time were analyzed. Results The ratio of male to female was 1:1.83 and the average age of onset was 60 ± 8.8 years old. Most of them presented with walking unstable (82.4%)and hypomnesia (64.7%) as the initial symptom. The occurrence rate was 82.4%, 76.5%and 58.8%for myoclo?nus, colored-ribbon-shaped high signals in cerebral cortex and high signals in basal ganglia of MRI. Periodic synchro?nous discharge (PSD) of electroencephalography(EEG) was seen in 82.4% cases, while cerebrospinal fluid analysis re?vealed positive results for 14-3-3 protein in 70%cases. Twelve patients had been dead in our study. The median surviv?al time was 12±7.7 months. Conclusions sCJD is more frequently occurred in mid-aged and older without specific symp?toms in early stage and positive rate of high signals in cerebral cortex of MRI and PSD of EEG is high.

Objective To evaluate the effect of integrative therapy and influencing factors in patients with intractable constipation (IC). Methods Eighty-four consecutive IC patients were divided into non overlap and overlap groups. All patients received individualized integrative therapeutic regimen for 4 weeks. The symptom scores of constipation and total effective rates were evaluated. Influencing factor of therapeutic effect in IC was analyzed.Results (1) IC of overlap group and non overlap group accounted for 40.5% (34/84) and 59.5% (50/84), respectively. (2)The total effective rates were 50.0% and 78.0% in overlap and non-overlap group, respectively(P

Aim To investigate the role of adrenomedullin on cell proliferation in renal interstitial fibrosis mice. Method Renal interstitial fibrosis model was induced with unilateral ureteral obstruction (UUO) and valsartan(10 mg?kg?d-1) was given by gavage. Immunohistochemistry and RT-PCR were used to detect expressions of PCNA, Col Ⅲ and TGF-?_1 in the kidney of wild type (WT) and adrenomedullin knockout (AMKO) +/-mice. Results The number of PCNA positive cells was increased in WT-UUO group compared with WT sham group and was partially reduced by Valsartan in WT-UUOV group. AMKO group showed higher expression of PCNA than WT group, and it increased more remarkably in AMKO-UUO mice but was reduced by Valsaltan in AMKO-UUOV group. Expressions of Col Ⅲ andTGF-?_1 were upregulated in AMKO-UUO mice, and this change was inhibited by Valsaltan.Conclusion Adrenomedullin play an important role in the process of cell proliferation in renal interstitial pathological changes by UUO.