Objective To investigate the management of external iliac artery mycotic hemorrhage after kidney transplantation. Methods A case of external iliac artery mycotic hemorrhage after kidney transplantation managed by the use of hypogastric artery autograft was reported with review of the literature.The massive blooding occurred 3 times after kidney transplantation in a male patient 25 years of age on the 22nd,24th and 38th day after transplantation.The blooding amounted to 800 ml,2500 ml and 3800 ml respectively.The blood loss was replaced and prompt surgical exploration was carried out with the blooding site at the anastomosis sutured up on the 1st and 2nd episode of bleeding.On the 3rd occurrence of bleeding, the diseased external iliac artery segment, about 2cm in length, was resected and the gap was replaced by a 3cm long hypogastric artery autograft. Results The blood flow through the repaired external iliac artery and the blood supply to the lower extremity was adequate.Periodic hemodialysis had been restored and the patient waited for reimplantation. Conclusions External iliac artery mycotic hemorrhage after kidney transplantation is a serious and fatal complication.Simple arterial repair is usually noneffective.Resection of the diseased mycotic segment of the external iliac artery with repairing of the gap with a hypogastric artery autograft is rational,feasible and simple.The procedure is highly recommended.

Objective To study the resuscitative effect of hypertonic electrolyte glucose solution (HEGS) on the haemodynamics pa-rameters in enteral resuscitation of burn shock. Methods Eighteen beagle dogs with 35% TBSA third degree burned were used in this stud-y. They were random divided into no-resuscitation group (NR group), enteral resuscitation with HEGS group (EH group) and intravenous resuscitation with isotonic electrolyte glucose solution (lEGS) group (Ⅱ group). The fluid resuscitation was given from half an hour after TBSA). The haemodynamics parameters (cardiac index, mean arterial pressure, intrathoracic blood volume index, and systemic vascular re-sistance index) were continuously assessed by PICCO. Result The cardiac output index reduced markedly after bum in the three groups, and then returned after 2h in two resuscitation groups, which were higher than that in the NR group( P<0.05). The mean arterial pressure reduced in the three groups, which was higher in the two resuscitation groups than that in NR group(P < 0.05). The intrathoracic blood volume index was rapidly reduced in the three groups. It returned in EH group from 2 hours after burned, which was still higher than that in the other two groups (P < 0.05). Meanwhile the systemic vascular resistance index was increased quickly. It was reduced in EH group from 2 hours after burned, which was lower than that in the other two groups (P < 0.05). Conclusion The results show that it was feasible for 35% TBSAⅢ° burn-injury dogs to be resuscitated with 1.8% hypertonic electrolyte-glucose solution by enteral, which can markedly reduce liquid quantity needed.

Objective To investigate the hemodynamic change of venous leakage in venogenic impotence. Methods Thirty-two patients with vasculogenic impotence were evaluated with conventional penile duplex sonography with spectral analysis and color Doppler imaging after intracavernosal injection of PGE1 to induce an erection.The color Doppler appearance of deep dorsal vein of penis,cavernous veins and bulbourethral vein wen observed and the correlativity with resistance index(RI)of cavernous artery were analyzed. Results After five minutes following intracavernous injection,the flow and diameter of the penis vein were continuous increased.The coefficient correlation r between the discharge of deep dorsal vein of penis,cavernous veins and bulbourethral vein with RI of cavernous artery were-0.55,-0.53,-0.24(P＜0.05).Considering the existence of mixed venous leakage,r between the discharge of vein of penis with RI of cavernous artery was-0.88(P＜0.001).Conclusions Higher qualitative ultrasound imaging could demonstrate venous leakage sensitively and assess the location and degree of venous leakage in venogenic impotence initially.

Objective To investigate the management and prevention of the complications of sigmoid rectal pouch for urinary division after radical cystectomy. Methods The clinical data of 34 patients who underwent a sigmoid rectal pouch procedure were analyzed retrospectively, and the clinical experience was summarized in the management and prevention of the complications of sigmoid rectal pouch for diversion. Results Twenty-six patients were followed up for 2 months to 11 years, and 10 patients lost in follow-up. The early follow-up results were as follows:3 patients had postoperative high fever with unilateral the kidney water, 1 patient had retropubic bleeding and need to stop bleeding, 3 patients suffered from wound split open and were performed relaxation suture, and 1 patient had sigmoid colon rectum bladder fistula 10d after operation. The late follow-up results were as follows:1 patient had urethral neoplasms recurrence, 5 patients developed distance metastases, and 5 patients developed nocturnal incontinence and worn safety pad. There were no hyperchloremic acidosis requiring clinical treatment, hydronephrosis as well as retrograde pelvis infection. Conclusions The operation of sigmoid rectal pouch for urinary division is fairly simple, with no serious complication. It is a better alternative diversion procedure, and should be accepted gradually by patients and surgeons.

Objective: To detect the vascular paths in the lateral wall of maxillary sinus using cone beam computer tomography (CBCT), and to retrospect the surgical managements of avoiding bleeding complication during the lateral approach maxillary sinus elevation.Methods: The documents of 71 consecutive patients with 81 sides maxillary sinus elevation surgery were collected.The vascular paths in the lateral wall of maxillary sinus were detected by the preoperative CBCT, and the messages about the vascular in surgical records were analyzed.Results: The paths of the vascular could be detected in 77 (95.1%) sides maxillary sinus in the reconstruction panoramic images of CBCT.At the position of the first molar, the paths of the vascular of the lateral maxillary sinus walls could be detected in 54 sides (66.7%) in the reconstruction coronal images of CBCT, and the other 27 sides (33.3%) could not be detected.Two approximately parallel paths of the vascular were found in 3 sides (3.7%) of the lateral maxillary sinus walls.The different diagnoses occurred in 6 sinuses between two observers.The kappa of diagnostic consistency of the two observers was 0.842 (P<0.001).The mean distance between the lower border of the vascular path to the plane of the alveolar crest of 54 sides maxillary sinuses was about (13.0±4.7) mm.The mean distance between lower border of vascular path to the plane of the floor of the sinus was (9.3±4.8) mm.The vascular path was located in the floor wall in 1 sinus.During the lateral approach maxillary sinus elevation operation, intraosseous vessels were dissected in 4 sides sinus lateral wall, the vascular path was avoided consciously in 3 sides, and the sinus elevation surgery had to be given up in 1 side for the vessel was torn and bleeding.There were no vascular related messages in 73 sides of the lateral approach maxillary sinus elevation operation records.Conclusion: The vascular paths of maxillary sinus wall could be detected by CBCT in most cases.Preoperative CBCT examination was proved to be reliable.The vascular paths of maxillary sinus wall should be examined carefully.It was helpful to make the surgical design perfectible and reduce the risk of tearing the vessel in operation.

Objective To conduct a computer simulation to evaluate the discrepancy between the cumulative doses calculated by four-dimensional computed tomography (4DCT) images and 4DCT scans (for real-time respiratory motions) due to the patient's irregular breathing.Methods A series of digital phantoms were generated from a patient's 4DCT images to simulate 4DCT images and 4DCT scans (for real-time respiratory motions) resulting from various irregular breathing curves.A six-field intensity-modulated radiotherapy plan was generated.Two cumulative doses in the target were calculated.The first one, named Dall, was calculated by tracking the point displacements in the target manifested on the 4DCT images;the second one, named D4D, was calculated based on the point displacements along the whole breathing motion during 4DCT scanning.Dose discrepancy between D4D and Dall was calculated to evaluate the correlation between breathing pattern and dose discrepancy in the target.Results The dose discrepancy in the target was correlated with mean motion excursion and the standard deviation of motion excursion.ΔDmin(ΔD99) in the target increased from 2.39%(2.04%) to 11.91%(5.24%) as the mean motion excursion increased from 5 mm to 15 mm, and increased from 5.93%(2.15%) to 14.65%(5.01%) as the standard deviation of motion excursion increased from 15% to 45% of the mean motion excursion.When the mean period increased from 3 s to 5 s or the standard deviation of period increased from 10% to 40% of the mean period,ΔDmin(ΔD99) in the target was greater than 6.0%(2.0%), but less than 9.0%(3.0%).When the target diameter was 2 cm, 3 cm, and 4 cm,ΔDminΔD99) in the target was 11.88%(5.50%), 6.91%(2.42%), and 7.53%(3.62%), respectively.Conclusions There is a large discrepancy between the cumulative doses calculated using 4DCT images and 4DCT scans (for real-time respiratory motions) when the patient has irregular breathing.This dose discrepancy depends on mean motion excursion and the standard deviation of motion excursion, but has little relationship with mean period, the standard deviation of period, and tumor volume.

Objective:To analyze the influence of tracking error of Xsight lung tracking system caused by cardiac beating.Methods:48 patients with lung tumors adjacent to the heart were enrolled into this study. The tumor movement curves were collected by the Xsight lung tracking system and recorded in the treatment log files during the Cyberknife treatment process. The curves were subject to filtering analysis and the respiratory motion of < 1 Hz and the cardiac beating motion of > 1 Hz were separated. According to the filtering results, the patient treatment tracking data were divided into two groups based on whether the cardiac beating wave of >1 Hz existed. The tracking errors were statistically compared between two groups based on the X-ray imaging data collected by Xsight lung tracking system during treatment.Results:For the fractionation with cardiac beat information, the tracking errors of the patient′s related models were (1.45 ± 0.99), (0.46 ± 0.21) and (0.70 ± 0.54) mm in the left-right, superior-inferior and anterior-posterior direction, respectively. For the fractionation without cardiac beat information, the tracking errors of the patient′s related models were (1.52 ± 1.17), (0.63 ± 0.37) and (1.07 ± 0.62) mm in the left-right, superior-inferior and anterior-posterior direction, respectively. The tracking errors in the superior-inferior and anterior-posterior direction of patients with accurate cardiac beat models were 28.34% and 34.86% less than those of their counterparts without accurate cardiac beat models and there was significant difference (both P<0.05). Conclusion:The tracking accuracy of Xsight lung tracking system will be significantly improved if the cardiac beat model is accurately established.

Objective To evaluate the value of DWI and ADC value in monitoring the chemotherapy response of advanced gastric carcinoma dynamically.Methods 42 advanced gastric carcinoma patients who were confirmed by histopathology underwent T2 WI and DWI examinations at pre-chemotherapy,post-chemotherapy 3 d,7 d,30 d and 60 d respectively.The longest diameters of tumor pre-chemotherapy and post-chemotherapy 60 d were measured on axial T2 WI,meanwhile the ADC values at different time points were calculated.The mean ADC value among pre-and post-chemotherapy of each group (PR and SD)was compared.Results The ADC value of PR group increased gradually.The mean ADC value before therapy was statistically lower than those at differ-ent time points post-chemotherapy (P < 0.05).The ADC value of SD group increased gradually from pre-chemotherapy to post-chemotherapy 30 d,and then the ADC value decreased at post-chemotherapy 60 d.The differences of the mean ADC values in differ-ent time points were statistically significant (P < 0.05).Conclusion DWI and ADC value can dynamically,quantitatively and early detect and monitor the chemotherapy response of advanced gastric carcinoma.

The importance of NAC (named as NAM, ATAF1, 2, and CUC2) proteins in plant development, transcription regulation and regulatory pathways involving protein-protein interactions has been increasingly recognized. We report here the high resolution crystal structure of SNAC1 (stress-responsive NAC) NAC domain at 2.5 Å. Although the structure of the SNAC1 NAC domain shares a structural similarity with the reported structure of the ANAC NAC1 domain, some key features, especially relating to two loop regions which potentially take the responsibility for DNA-binding, distinguish the SNAC1 NAC domain from other reported NAC structures. Moreover, the dimerization of the SNAC1 NAC domain is demonstrated by both soluble and crystalline conditions, suggesting this dimeric state should be conserved in this type of NAC family. Additionally, we discuss the possible NAC-DNA binding model according to the structure and reported biological evidences.
Amino Acid Motifs ; Amino Acid Sequence ; Conserved Sequence ; Crystallography, X-Ray ; DNA ; metabolism ; Models, Molecular ; Molecular Sequence Data ; Oryza ; metabolism ; physiology ; Plant Proteins ; chemistry ; metabolism ; Promoter Regions, Genetic ; genetics ; Protein Multimerization ; Protein Structure, Quaternary ; Protein Structure, Tertiary ; Stress, Physiological

Objective Since it is a common problem for medical practice that paper instructions for medicine information are difficult to update and inconvenient to search ,this article is to provide convenient service of pharmacy information for clini-cal practice by developing medicine information search software in our hospital .Methods According to the practical needs of clinical study and pharmacy research ,we took appropriate measures to collect data ,categorize contents ,scan pictures ,polish images and extract information for the medicine instructions .Based on the above work ,we applied Oracle 10G to establish medicine information database for our hospital and utilized Java to design medicine information search software .Results Our search software includes 1 201 kinds of medicines ,taking up 98 .85% of the medicines in our catalogue .The users can use four different search methods (including common name search ,commodity name search ,fuzzy search and key word search) to gain the written material and photographic information of medicine instructions .Conclusion With the help of the software of Oracle and Java ,the newly designed software for medicine information search can provide convenient pharmacy information service for clinical practice .