Objective To determine the value of MR cholangiography(MRC)in the preoperative evaluation of biliary anatomy of living liver donors.Methods Fifty eight consecutive donors underwent MRC examinations and living liver transplantation.MRC was performed on a 1.5 T scanner with breath-hold rapid acquisition of T_2WI slab and breathing-gating 3D FSE T_2WI.Images of MRC and IOC were compared and classified according to the modified Huang's classification.Results Thity four(58.6%)liver donors showed normal biliary anatomy on IOC,and 24(41.4%)donors revealed variant bile anatomy.MRC correctly depicted biliary anatomy in 91.4%(53/58)donors.The sensitivity,specificity,positive predictive value and negative predictive value of MRC in distinguishing normal and difierent types of variant biliary anatomy were 83.3%(20/24),100%(34/34),100%(20/20),89.5%(34/38)respectively.Conclusion MRC can accurately assess the biliary anatomy in living liver donors and may guide the preoperative planning of liver transplant.

0.05).Conclusion The standard test methods are more effective in detecting G.lamblia than C.parvum.No G.lamblia and C.parvum contamination has been found in drinking water in the Tianjin and Shenyang.

0.05). Lornoxicam caused less side effects than morphine (10.2% vs 17.9%) Conclusions The study suggests that lornoxicam provide an alternative to morphine for the treatment of postoperative pain.

BACKGROUND: Studies have shown that stability of artificial joint prosthesis is highly correlated with medullary cavity matching.However, whether medullary cavity appearance and diameter changes with age, ultimately affecting prosthesis and medullary cavity match remains unclear.OBJECTIVE: To evaluate the effect of age on femoral medullary cavity morphology and geometric parameters, and observe medullary cavity changes with age so as to guide prosthesis selection and operation and improve long-term survival of prosthesis.DESIGN, TIME AND SETTING: Comparative observation of morphology. The experiment was performed at the Department of Orthopedic Surgery, Beijing Friendship Hospital Affiliated to Capital Medical University from August 2007 to April 2008. PARTICIPANTS: A total of 100 healthy female and male people were selected from Orthopedics Outpatient Department.Informed consent was obtained from all subjects.METHODS: All patients underwent a left full-length femoral CT scanning, 150 kV, 100 mA. The images were reconstructed and measured at the PICKER 2000 Voxel Q station.MAIN OUTCOME MEASURES: The contents of 36 data collected from the patients included general information of the patients,the external parameters of femur, radius-length parameters of femoral medullary cavity and morphological parameters of femoral medullary cavity.RESULTS: Among all femoral parameters, the site of isthmus altered significantly with aging (P< 0.05). The anterior and posterior cortical thicknesses of isthmus and medullar anteroposterior diameters of isthmus changed significantly with age in female group (P < 0.05), but were not changed significantly in male group (P > 0.05).CONCLUSION: As for the prosthetic design, the shape design of prosthesis needs not to change with aging for male or female. Properly lengthening the femoral stem will help to get best fit of prosthesis. Proximally fixed femoral prosthesis seems to have superiority theoretically for elderly female patients.

Objective:To compare the cannulated screw fixation versus high-strength suture fixation in arthroscopy of tibial intercondylar fracture.Methods:A retrospective analysis was performed of the 31 patients with tibial intercondylar fracture who had been treated from February 2015 to February 2018 at Department of Orthopaedics, Beijing Renhe Hospital. They were 18 males and 13 females with an average age of 34.3 years (range, from 21 to 51 years). Arthroscopic cannulated screw fixation was conducted in 13 patients (screwing group), 5 of whom were McKeever type Ⅱ and 8 of whom McKeever type Ⅲ. Arthroscopic high-intensity suture fixation was used in 18 patients (suture group), 6 of whom were McKeever type Ⅱ and 12 of whom McKeever type Ⅲ. The 2 groups were compared postoperatively in terms of operation time, hospitalization time, fracture healing time, Lysholm knee scores and rate of secondary operation.Results:The 2 groups were comparable because there were no significant differences in preoperative general data between them ( P>0.05). All the patients were followed up for 12 to 44 months (mean, 24.8 months). For the screwing and suture groups, respectively, operation time was 91.6 min±7.6 min and 91.9 min±7.4 min, hospitalization time 11.5 d±2.9 d and 11.4 d±2.3 d and fracture healing time 3.3 mon±0.5 mon and 3.3 mon±0.6 mon, showing no significant differences between the 2 groups ( P>0.05). By the Lysholm scores at 12 months after operation, the screwing group scored from 65 to100 points with an excellent and good rate of 92.3% (12/13), and the suture group from 60 to 100 points with an excellent and good rate of 94.4% (17/18), showing no significant difference between the 2 groups ( P>0.05). Ten patients (76.9%) in the screwing group had secondary arthroscopy to remove the implants but none in the suture group did. Conclusions:Both cannulated screw fixation and high-strength suture fixation can achieve satisfactory clinical results in the arthroscopy of tibial intercondylar fractures, but the latter may lead to a lower rate of secondary operation.

The results of different interventions administered in 118 cases with impaired fasting glucose (IFG) for 3 years were investigated. The rates of transformation of IFG to diabetes mellitus in metformin treatment groups and rosiglitazone treatment groups were significantly lower than that in life style intervention group. This study suggested that metformin or rosiglitazone treatment could effectively reduce transformation of IFG to diabetes as compared with life style intervention.

Objective To study the effects of oral rehydration with the solution of pyruvate-glucoseelectrolyte (PGES) by comparison with the bicarbonate-glucose-electrolyte solution (BGES) on resuscitation in rats with lethal hemorrhagic shock.Methods Sixty adult male SD rats with intra-gastric tube,and cannulation of femoral artery and vein were subjected to 45％ total blood volume loss from the femoral artery,and then randomly divided into three groups (n =20 in each group):no fluid resuscitation group (NR),oral fluid resuscitation with the PGES group (PGES) and oral fluid resuscitation with the BGES group (BGES).In NR group,the animals received no fluid replacement or any other treatment.Rats in PGES and BGES groups were infused intra-gastrically with pre-warmed PGES or BGES in volume of 2 times shed blood given at 30 min after hemorrhage and completed within 6 hours.Blood samples in each group were collected from the abdominal aorta before or at 0,1,2,4 h post hemorrhage to detect serum alanine aminotransferase (ALT),creatinine (Cr),creatine phosphate kinase isoenzyme (CK-MB) and intestinal fatty acid binding protein (iFABP).Another 84 rats randomly divided into four groups:NR group (n =24),PGES group (n =24),BGES group (n =24),and no hemorrhage group (NH group,n =12).Rats in the three hemorrhage groups were treated the same as described above,and the rats in NH group underwent the same surgical procedure without hemorrhage were served as the sham group.All these rats were observed for their 24-hour survival rates.Results The 24-hour survival rates of PGES and BGES groups were both significantly higher than the rate of NR group (11/24 vs.1/24,x2 =18.087,P ＜0.01 ; 5/24 vs.1/24,x2 =6.445,P ＜ 0.05) ; the survival rate of PGES group was also significantly higher than that of BGES group (11/24 vs.5/24,x2 =4.02,P ＜ 0.05).All levels of ALT,CK-MB,Cr and iFABP in both the NR group and two oral resuscitation groups at 1 h,2 h and 4 h post hemorrhage were significantly higher than those before the blood loss,respectively (P ＜ 0.01).These biomarkers at 2 h,4 h post hemorrhage were significantly lower in the PGES and BGES groups than those in NR group (P ＜ 0.01) ; the serum levels of ALT,CK-MB,Cr and iFABP were significantly lower in the PGES group than those in the BGES group at 2 h and 4 h post hemorrhage,respectively (P ＜ 0.05).Conclusions Present results demonstrated that the pyruvate-enriched oral re-hydration solution (ORS =PGES) was more effective in preserving the organ function and prolonging the animal survival after resuscitation of lethal hemorrhagic shock in comparison with the bicarbonate-containing ORS (BGES).The oral re-hydration solution (PGES) recommended by the World Hygiene Organization (WHO ORS) may require further improvement in oral resuscitation of shock and the PGES may be recommended as a choice of oral re-hydration salts in the treatment of lethal hemorrhagic shock when intravenous administration is not available.

Objective To investigate the effects of fragile X mental retardation protein（FMRP）on the development and migration of cerebellar neurons in mouse model.Methods Plasmids containing FMRPmutant-EGFP or EGFP were established and transfected into the lateral ventricle of the embryo mouse.Fragile X syndrome（FXS）genotype of the mouse model was identified.Nissl staining and immunofluorescence staining were conducted to assess the changes in neuron development and migration.Results In the experimental group,Nissl staining showed that the deep cerebellar neuclei contracted and divided by white matter,and the non-polarized Purkinje cells retained in internal granular layer;while immunofluorescence staining showed that Tbr2-positive unipolar brush cells changed the migration pathway and accumulated in the ventricular zone.Conclusion Cerebellar neurons showed abnormal formation and migration with the absence of FMRP.

Objective To assess the expression and significance of proprotein convertase subtilisin kexin 9 (PCSK9) in patients with rheumatoid arthritis (RA).Methods Sixty-five RA patients and forty-seven healthy controls were recruited in this study.The body mass index (BMI) and serum total cholesterol (TC),triglyceride (TG),high density lipoprotein (HDL),lipoprotein a,low density lipoprotein (LDL),very low density lipoprotein(VLDL),apolipoprotein A (ApoA),apolipoprotein B (ApoB) and the ratio of LDL-C/HDL-C were tested.Other parameters included disease activity score 28 (DAS28),rheumatoid factor (RF),anti-cyclic citrullinated peptide (CCP) antibody,erythrocyte sedimentation rate (ESR),c-reactive protein (CRP).Serum PCSK9 level was measured by ELISA and compared between RA patients and healthy controls.Results (1) The serum PCSK9 levels in RA patients were higher than those in healthy controls [(409.36 ±223.52) μg/L vs (292.19 ± 109.79) μg/L,P ＜ 0.05].(2) Compared with subgroup of moderate and low active disease and patients in remission,PCSK9 was significantly higher in patients with highly active disease (P ＜ 0.05).(3) The serum PCSK9 levels were positively correlated with RF,TC,TG,LDL,very low density lipoprotein (VLDL),ApoB,with r values as 0.303,0.490,0.320,0.451,0.319,0.463,respectively (P ＜ 0.05).(4) Multiple stepwise regression analysis showed that DAS28,RF,TC and LDL-C/HDL-C were relevant factors for PCSK9 in RA patients.Conclusions The serum PCSK9 level is elevated in RA patients,which is related to RF,disease activity,TC,TG,LDL,VLDL,ApoB.This suggests that PCSK9 is potentially linked to inflammatory reaction and lipid metabolism in rheumatoid arthritis.

Objective To investigate the regularity of intrapulnonary lobar and segmental lymph nodes metastasis in patients with cT1N0M0 stage lung adenocarcinoma.To provide a basis for more accurate determination of N stage and indication for pulmonary segmental resection.Methods A prospective study was performed from March 2014 to December 2015.103 cases of cT1 N0M0 stage lung adenocarcinoma received lobectomy and mediastinal lymph node dissection in the thoracic surgery department of China-Japan Friendship Hospital.Intrapulmonary lobar and segmental lymph nodes were dissected and sorted carefully then sent to the pathological department with the corresponding lung specimen and other lymph nodes.Statistical analysis was carried out considering size of the lesion,imaging features,serum CEA levels,pathological subtypes and so on.Results In total 103 cases,pN0 was confirmed in 82 cases,pN1 in 15 cases,pN1 + N2 in 5 cases,and skipping-pN2 in 1 case.14 cases(93.3％) in pN1 group were detected with station 12-14 lymph node metastasis,while only 5 cases (33.3％) were detected with station 12-14 LSNs metastasis.4 cases(66.7％) in pN2 group were detected with station 12-14 lymph node metastasis,while only 1 case(16.7％) with station 13 and station 7 lymph node metastasis.If LSNs were not detected,the false negative rate of N staging could be as high as 6.1％ (5/82),The rate of missed diagnosis of lymph node metastasis might be 30％ (6/20) to N1 stations alone.41.2％ (7/17)cases with metastasis to the adjacent LSNs had been proved with metastasis to the isolated LSNs.The metastasis rate of the isolated LSNs was significantly lower(P =0.049) in pure GGNs compared with those part-solid/solid nodules.Invasive adenocarcinoma had higher metastasis rate of isolated LSNs,compared with preinvasive lesions or minimally invasive adenocarcinomas,with no statistical difference between groups (P =0.055).No significant difference in isolated LSNs metastasis rate was found between groups with different serum CEA levels(P =0.251) or tumor size(P =0.197).Conclusion Dissection of intrapulmonary lobar and segmental lymph nodes might facilitate a more accurate N stage,reduce the false negative rate of lymph node metastasis,and provide basis for more accurate assessment of prognosis and postoperative adjuvant treatment.The sampling area of lymph nodes during segmental resection should include the adjacent LSNs of the target segment.The isolated LSNs metastasis rate of cT1N0M0 stage lung adenocarcinoma with pureGGN as imaging feature is relative low,which might be suitable for segmentectomy when meeting other criteria.