Objective To investigate the effect of different concentrations of heparin in the cold preservation solution on blood coagulation after reperfusion during orthotopic liver transplantation ( OLT) . Methods Forty ASA Ⅱ or Ⅲ patients with end-stage liver disease (31 males, 9 females) weighing 51-82 kg undergoing OLT were randomly divided into 3 groups according to the concentrations of heparin in the liver preservation solution: group Ⅰ 2 000 U?L-1( n = 14); group Ⅱ 8000 U?L-1(n= 12) and group Ⅲ 20 000 U?L-1(n = 12) .Anesthesia was induced with propofol, fentanyl and rocuronium and maintained with isoflurane inhalation and intermittent i.v. boluses of fentanyl. Body temperature was maintained at 35.5-37.5℃ and Hct at 22%-35% . Blood samples were taken from central vein at 15 min before reperfusion (T0,baseline) and 5, 30, 60, 120 and 180 min of reperfusion (T1-5) for determination of ACT, CR and platelet function (PF) using Sonoclot platelet function and coagulation analyzer (U.S.A.). Blood concentration of heparin was determined in 3-4 patients in each group at T0-5 ( HPLC) . Results The 3 groups were comparable with respect to age, body weight, ASA physical status and Child classification. The glass ball activated coagulation time (gbACT) was significantly prolonged at T1-4 in group Ⅲ and at T1,2 in group Ⅱ as compared to the baseline values at T0 ( P

Abdominal Neoplasms ; metabolism ; pathology ; surgery ; Actins ; metabolism ; Angiomyolipoma ; metabolism ; pathology ; Desmin ; metabolism ; Diagnosis, Differential ; Humans ; Leiomyosarcoma ; metabolism ; pathology ; surgery ; Liposarcoma ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Retroperitoneal Neoplasms ; metabolism ; pathology ; surgery ; S100 Proteins ; metabolism

AIM To observe the clinical efficacy of Huazhi Rougan Granules (Artemisiae scopariae Herba,Cassiae Semen,Rhei Radix et Rhizoma,etc.) in the treatment of damp-heat accumulation type non-alcoholic steatohepatitis (NASH) and its influence on insulin resistance.METHODS During January 2014-January 2016,a total of one hundred and twenty patients with damp-heat accumulation type NASH,given diet and exercise guidance,were randomly and equally divided into control group (polyene phosphatidylcholine) and treatment group (Huazhi Rougan Granules),administrated for twelve weeks.The levels of serum alanine aminotransferase (ALT),aspartate aminotranferase (AST),gamma-glutamyltransferase (GGT),total cholesterol (TC),triglyceride (TG),γ-glutamyl transpeptadase (GGT),fasting plasma glucose (FPG),fasting insulin (FINS),HOMA-IR index,adiponectin (ADPN) and leptin,body mass index (BMI) and uhrasound examination were detected before and after the treatment,respectively.These data were compared in two groups.RESULTS Compared with the control group,the serum ALT,AST,GGT,TC,TG,FPG,FINS and HOMA-IR of the patients in the treatment group decreased significantly,and liver fat were effectively reduced,while serum adiponectin increased markedly (P ＜ 0.05).After the treatment,remarkable reductions in the levels of BMI,leptin were observed in both groups (P ＜ 0.05).CONCLUSION Huazhi Rougan Granules combined with lifestyle modulation can effectively improve the syndrome of damp-heat accumulation type NASH by lowing insulin resistance.

The connotations of "du-fu" and "Sanli" in "Sanli acupoint for du-fu diseases" are discussed in this paper, which can provide theoretical foundation for the clinical application of "Sanli acupoint for du-fu diseases". Based on ancient literature combined with related theories in the Huangdi Neijing (Yellow Emperor's Canon of Internal Classic), a deep discussion is performed through the relationship between Zusanli (ST 36) and stomach, indication and mechanism of Zusanli (ST 36) on du-fu diseases and comparison between Zusanli (ST 36) and Shousanli (LI 10). It is believed that "du" should be pronounced as "dŭ", meaning stomach, and it indicates that Zusanli (ST 36) is closely related to stomach and spleen when it is used for du-fu diseases; "fu" means abdomen area, including liver-gallbladder, spleen, stomach-intestine, kidney, uterus, triple energizer; "sanli' means exclusively the acupoint of Zusanli (ST 36).
Abdominal Cavity ; anatomy & histology ; Acupuncture Points ; Acupuncture Therapy ; history ; Books ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Meridians

AIM:To study the human brain hemodynamics responses induced by acupuncturing foot shaoyang gallbladder meridian point GB37 and visual stimulation,and to analyze the effect of acupuncture to activate the cerebral functional area in visual stimulus. METHODS:Twenty five normal subjects were divided into two groups:15 subjects for electro -acupuncture GB37 in visual stimulus group and 10 subjects for electro-acupuncture GB37 groups. The blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) was carried out under the condition of two dif-ferent stimulation patterns (including a vision stimulation task and point GB37 acupuncture under the vision stimulation condition). A scintillating chessboard grid was applied as the vision stimulation task and the frequency was 8 Hz. The activation of cerebral functional areas of tested people under the conditions of the vision stimulation task and acupuncture were analyzed,respectively. RESULTS:Out of 15 subjects of electro -acupuncture GB37 in visual stimulus groups,twelve health volunteers were enrolled. When the vision stimulation task was carried out,the alarge area of brainstem and posterior lobe of cerebellum was seen to be activated. The areas of limbic lobe,hippocampus,middle temporal gyrus and inferior temporal gyrus were also activated. Under the condition of acupuncture only,the areas of posterior central gyrus,inferior parietal lobule,parietal lobe precuneus and the middle frontal gyrus were activated. When doublesided points of gallbladder meridian of foot-shao-yang were electroacupunctured under the visual stimulus status,the areas of superior frontal gyrus,inferior frontal gyrus,parietal precuneus and occipital gyrus lingualis were activated. CONCLUSION:The functional MRI shows the activation of cerebral functional area after acupuncture. Visual stimulus causes significant changes of brain conduction path connection. Under the visual stimulus status,the acupuncture to the points of gallbladder meridian of foot -shao -yang,GB37 has an extent of influence to conduction path conformity of the vision system and with the treat-ment of ophthalmocace. Furthermore,the external stimulation has prominent influence to the acupuncture therapy possibly.

Objective To summarize the important HR-MRI manifestations of orbital disease in extraconal compartment.Methods Forty-four patients with extraconal orbital disease identified pathologically were analysed retrospectively. MRI of the orbit at 1.5 Tesla was performed with surface coil, thin slice, suitable bandwidth, small field of view (FOV) and large matrix. The analyzed criteria of imaging appearance were: location, shape,size, margins, extent, adjacent structures, and signal intensity.Results Lymphoma, hemangioma, rhabdomyosarcoma, metastasis, pseudotumor, and phlegmon accounted for 70% of all extraconal orbital diseases. Three cases of haemangioma had round shape and clear margin; most lymphoma had irregular shape, unclear margin and big volume; while most rhabdomyosarcoma and metastasis had round shape and unclear margin. The effect of space-occupying of lymphoma was not obvious. One case of lymphangioma had high signal intensity on both T 1- and T 2-weighted images without enhancement. Melanomametastasis appeared hyperintense on T 1- weighted and hypointense on T 2-weighted images. The contrast-enhancement of haemangioma was much more prominent than others. There were characteristic of rhabdomyosarcoma, metastasis, pseudotumor, and phlegmon about their age,clinical history and examination. Conclusion Location criteria, morphological changes, MRI signal intensity, clinical history and the effect of space-occupying are very useful in the differential diagnosis of the orbital disease.

Objective:To eveluate and study the anatomic basis of the posterior contour sign of lumbar intervertebral disc.Methods:The most protruding length of the soft tissue mass behind intervertebral spase on lumbar plain film were measured in 100 cases and compared with CT or MR findings.Results:41 posterior contour sign of the interlumbar disc were fined in 39 cases,of which there were 25 in L4/5(61.0%),15 in L3/4(15.6%)and 1 in L2/3(2.4%).The protruding was less than 0.2 cm in 26 and larger than 0.2 cm in 15,there were 10 lumbar disc protruding confirmed by CT or MR ,7 of which the pesterior contour ≥0.2 cm,and 3＞0.3 cm,none was ≤0.2 cm.Conclusion:The adipose tissue in the posterior border of lumbar body and disc was the anatomic basis of the sign,and it was an importent sign for diagnosing of lumbar disc hernia on plain film.

Objective To investigate the clinical efficacy and indication of surgical treatment of L5S1 tuberculosis us?ing a medial edge of rectus abdominal muscle and retroperitoneal approach. Methods From Jan. 2010 to Nov. 2014, totally 18 cases of L5S1 tuberculosis were surgically cured by debridement, fusion and internal fixation via a medial edge of rectus ab?dominal muscle and retroperitoneal approach. There were 10 males and 8 females, with an average age of 35.6±10.1 years (21 to 55). The mean course of disease was 5.3±2.2 months. The primary destruction lesions were located at L5S1, and one patient of whom L4 was also involved, three cases S2 involved, and one S3 involved. Abscess pre sacrum was noticed in all cases. Six patients were combined with abscess in vertebral canal. Neural deficiency was detected in 3 patients, all grading as Frankel D. Dubousset's lumbosacral angle was 104°-126°, mean 114.6°±6.0°. Formal anti?tuberculosis medicine treatment was given for at least 2-3 weeks. All patients were treated using a medial edge of rectus abdominal muscle and retroperitoneal approach. Af?ter debridement, a tri?cortical iliac bone was used for structural inter?vertebrae fusion. The iliac bone was fixed to the sacrum by one cortical screw. Operation time, volume of blood loss, and surgery complications, including wound infection, looseness and shift of internal fixation, sinus occurrence, vascular injury, retrograde ejaculation in male patients were evaluated. The X?ray and 3D CT of lumbosacral spine, together with ESR and CRP were used to evaluate the control of tuberculosis during fol?low?up. The Dubousset's lumbosacral angle, visual analogue score, and the Frankel grade were compared between preoperative and postoperative. The bone graft fusion were also observed. Results The operation time was 147±16 min in average. The mean blood lose was 275 ± 77 ml. No vascular or neurological injury was noticed. There was also no retrograde ejaculation happened in this group. All patients were followed up from 18 to 28 months. Dubousset's lumbosacral angle was 122.4°±3.8° post?operatively and 121.4°±3.7° at the final follow?up. There was a significant difference between the lumbosacral angles pre and post operation, whereas no statistical difference between the post operation and the final follow?up. Bone fusion was noticed in all cases. All pa? tients have intact neurological function at the final follow?up. No screw breakage or graft bone migration occurred. VAS was 5.6± 1.09 pre?operation and 0.83±0.71 at the 3rd month's follow?up, and there was a significant difference between them. Conclusion Surgical treatment of L5S1 tuberculosis by debridement, fusion and internal fixation via a medial edge of rectus abdominal muscle and retroperitoneal approach is an effective method in terms of minimal trauma, low rate of modality, good ability in restore and maintenance of lumbosacral junction alignment and high fusion rate.

To lay a foundation for the type selection of the ambulance helicopter. The type selection was explored from the aspects of platform selection, rescue environment and service requirements, analyzing the rescue in the helicopter and the tendency of the ambulance helicopter in foreign countries and China. The types of the am-bulance helicopter were determined as the specific and modified ambulances, with the considerations such as operation environment, flight performance, cabin structure, onboard equipment, cabin configuration, fixation device and protection. Specific ambulance helicopter is supposed to be based on small- or mediate-sized platform, while the modi-fied ambulance helicopter is supposed to be based on large or heavy platform.

Objective To assess the diagnostic value of coronary CTA (CCTA) combined myocardial CT perfusion imaging (CTP) in coronary artery disease (CAD) with Meta-analysis.Methods Chinese and English literatures evaluating CCTA combined CTP in diagnosis of CAD in PubMed,Wed of Science,Cochrane Library,China National Knowledge Infrastructure (CNKI) and Wanfang Periodical Database from inception to December 2016 were searched.The extraction was conducted according to the criteria for diagnostic recommended by Cochrane Method Group.The quality of included studies was assessed with quality assessment of diagnostic accuracy studies-2 instrument.The statistical analysis was performed by Meta-disc 1.4 software,the diagnosis efficacy was calculated and the symmetric receiver operating characteristic curves (SROC) was drawn to obtain the area under curve (AUC).Results Five studies involving a total of 611 vessels were included.The pooled sensitivity (SEN),specificity (SPE),diagnostic odds ratio (DOR),positive likelihood ratio (PLR),negative likelihood ratio (NLR) were 0.96 (95％CI [0.92,0.98]),0.91 (95％CI [0.88,0.94],206.14 (95％CI [100,424.94]),9.33 (95％CI [5.57,15.61]),0.06 (95％CI [0.03,0.13]),respectively.The AUC of SROC was 0.977.Conclusion CCTA combined CTP has significant value in diagnosis of CAD.