Esophageal Achalasia ; surgery ; Esophagus ; pathology ; surgery ; Humans ; Surgical Procedures, Operative ; methods ; trends

Cardia ; Esophageal Neoplasms ; surgery ; Humans ; Neoplasm Recurrence, Local ; surgery ; Reoperation ; Stomach Neoplasms ; surgery

Objective To study the value of plasma D-dimer ＜ 500 μg/L level in diagnosis of pulmonary thromboembolism occurred in patients.Methods The clinical data of the patients with pulmonary embolism confirmed by imaging examination with plasma D-dimer levels ＜ 500 μg/L admitted from January 1st 2008 to June 30th 2011 were analyzed retrospectively.Results Totally,there were ten pulmonary embolism patients with plasma D-dimer levels ＜ 500 μg/L.The 10 eligible patients were assessed for the possibility of pulmonary embolism by using the Wells score (i.e.Wells clinical pretest probability prediction model).Of them,0 cases was evaluated as low clinical pretest probability (grade ＜2),7 cases as moderate clinical pretest probability (grade 2 ～6) and 3 cases as high clinical pretest probability (grade ＞ 6).Conclusions Pulmonary thromboembolism was easily misdiagnosed for lacking specific clinical manifestations and the missed diagnosis in patients caused high mortality,so it was difficult to exclude acute pulmonary embolism simply depending on the D-dimer levels ＜ 500 μg/L.Therefore,in case of plasma D-dimer levels less than 500 μ g/L,the possibility of pulmonary embolism cannot be ruled out in patients with moderate or high Wells clinical pretest probability.

11.0 mmol/L).Perioperative decontamination in digestive tract was a protective factor in the prevention of bacterial infection.Conclusion Bacterial infection is one of the most severe complications after OLT.Therefore,it is very important to remove those risk factors,make early diag- nosis and take effective treatment.

Objective To investigate the transactivating effect of hepatitis C virus(HCV)core protein on inducible nitric oxide synthase(iNOS)gene promoter and the molecular biological mecha- nisms of HCV pathogenesis.Methods Polymerase chain reaction(PCR)technique was employed to amplify the sequence of iNOS promoter by using HepG2 genomic DNA as template,and the product was cloned into pGEM-T vector.The iNOSp gene was cut from T-iNOSp by KpnⅠand XhoⅠ,and then was cloned into pCAT3-Basic,the constructed vector was named as pCAT3-iNOSp,pCAT3-iN- OSp was transfected into the LO_2 cell line.LO_2 cell was also cotransfected with pcDNA3.1(-)-core and pCAT3-iNOSp by FuGENE 6 transfection reagents.The LO_2 cells transfected with pCAT3-Basic was used as negative control.The activity of CAT in LO_2 cells was detected by an ELISA kit after 48 hours,which reflected the transactivating function of HCV core protein to iNOS gene promoter.Re- sults The expressive vector pcDNA3.1(-)-core and report vector pCAT3-iNOSp had been construc- ted and confirmed by restriction enzyme digestion and sequencing.The expression of CAT in LO_2 cells transfected with pCAT3-iNOSp and peDNA3,1(-)-core was 11 times as higher as that of pCAT3-bas- ic,and 6 times as higher as that of pCAT3-iNOSp.Conclusion It is suggested that HCV core protein can transactivate iNOS gene promoter.

ObjectiveTo assesses the skeletal development of adolescent in Yantai area, and investigates the characteristics of the tendency of their skeletal development. MethodsTotally 1180 healthy adolescents ( 574 males and 606 females ) at 10 to 20 years of age living in Yantai area were randomly selected, and their left wrist were radiated at the posterior-anterior position. The bones at wrist were scored according to the Chinese Wrist Skeletal Development Standard CHN Method. The correlation among skeletal age, chronological age and the sex were analyzed. ResultsSkeletal age positively correlated with chronological age (male: r=0.943,females: r=0.942,totally: r=0.942). ConclusionThe skeletal development of adolescent in Yantai area has the characteristic of acceleration. So it is necessary to establish a new skeletal age standard for the skeletal development of adolescent.

Objective To evaluate the efficacy and safety of intra?articular injections of tranexamic acid (TXA) on perioperative blood loss and transfusion in primary unilateral total knee arthroplasty (TKA). Methods Primary TKA was per?formed on a total of 380 patients (380 knees) affected to various degrees by knee osteoarthritis. All the patients are divided into three groups according to different joint injection for 5 min at the end of surgery in which:120 patients received 1.5 g TXA injec?tion,136 patients received 0.5 g TXA injection, 124 patients no pharmacological intervention (control group). Blood loss, hidden blood loss, blood transfusion, drainage volume and limb circumference change after TKA were assessed. Results All the surger?ies were well performed. No complication including infection, necrosis, and fat liquefaction has been observed. The results indicat?ed no significant difference with pairwise comparisons in intra?operative time, intra?operative blood loss, hospitalization time, anes?thesia, and drainage volume and limb circumference change. The mean postoperative hidden blood loss (1.5 g TXA group 693.29± 377.91 ml, 0.5 g TXA group 835.41±481.97 ml, the control group 1 032.75±322.19 ml) and transfusion (1.5 g TXA group 7.5%, 0.5 g TXA group 13.2%, the control group 20.2%) requests were significantly different with pairwise comparisons among the three groups. Compared with the control group, both 1.5 g TXA group and 0.5 g TXA group showed better effects (P<0.05). Compared with the 0.5 g TXA group, 1.5 g TXA group showed better effects (P<0.05). Conclusion It can be concluded that intra?articular injection of TXA in patients undergoing unilateral TKA could significantly reduce postoperative hidden blood loss and blood trans?fusion, and did not increase the risk of phlebothrombosis. This efficacy demonstrated a concentration dependent effect. Compared with 0.5 g TXA, 1.5 g TXA performed a better efficacy.