Objective:To summarize the anesthesia management of living small bowel transplantation.Methods:Severn patients undergoing living and allogeneic small bowel transplantation for the first time were selected.The intraoperative hemodynamics, indexes of blood gas analysis, body temperature and blood transfusion and volume of liquid infused were analyzed.Postoperative outcomes were tracked.Results:Six cases survived and were successfully discharged from hospital successfully, and one patient died.In the operation room, 71% patients were successfully extubated after surgery.Compared with the values during anatomical separation period, Hb during vascular anastomosis and intestinal reconstruction periods and concentration of Ca 2+ during intestinal reconstruction period were significantly decreased, and the blood glucose concentration during vascular anastomosis period were increased ( P<0.05 or 0.01). Compared with the values during vascular anastomosis period, the blood glucose concentration was increased significantly during intestinal reconstruction period ( P<0.05). Crystalloid solution (57±30) ml/kg and colloid solution which mainly containing 20% albumin (15±13) ml/kg were infused mainly during anatomical separation and vascular anastomosis periods in all the patients. Conclusion:The condition of successful living small bowel transplantation is fully evaluation and preparation before surgery.Intravenous-inhalational anesthesia combined with transverses abdominis plane block and rational infusion of colloid solution with vasoactive drugs to maintain hemodynamics stability and monitor blood gas, body temperature, active adjustment of electrolytes and internal environment and stable body temperature can be helpful in maintaining perioperative stable vital signs during the perioperative period, removing the tracheal tube early at the end of surgery, and reducing the development of postoperative complications in patients undergoing living small bowel transplantation.

Objective:To investigate the application and problems existing in the implementation of the standard of "Assessment for Therapeutic Efficacy of Kashin-Beck Disease" (WS/T 79-2011, referred to as new standard), and to provide technical basis and suggestions for further improving the standard.Methods:In 2019, a questionnaire survey was conducted and analyzed in Sichuan, Shaanxi, Qinghai and Gansu provinces and Tibet Autonomous Region on basic information, standard implementation, publicity, training and application of scoring method of joint dysfunction index of Kashin-Beck disease prevention and control technicians.Results:One hundred and thirty-four questionnaires were distributed in this survey and 132 valid questionnaires were recovered, of which 88.64% (117/132) of Kashin-Beck disease prevention and control technicians received training in the new standard and 89.39% (118/132) used the new standard; 78.03% (103/132) thought that the standard terms were clear and easy to master; 71.97% (95/132) thought it was simple, convenient and easy to operate; 49.24% (65/132) thought that the standard evaluation results were consistent with the actual improvement of patients, and 50.75% (67/132) thought that it was generally consistent; 72.73% (96/132) thought that the design was scientific, reasonable and feasible. When using the scoring method of joint dysfunction index, more than 90% of the technicians thought that the five index terms of "joint rest pain", "joint movement pain", "morning stiffness", "maximum walking distance" and "limb activity ability" were easy to understand and ask questions. When patients with Kashin-Beck disease were investigated, the constituent ratios of easy to understand the five index terms were 96.21% (127/132), 83.33% (110/132), 90.15% (119/132), 78.79%(104/132), 90.15%(119/132) and the constituent ratios of easy to answer were 95.45% (126/132), 83.33% (110/132), 89.39% (118/132), 75.00% (99/132) and 89.39% (118/132), respectively.Conclusions:The new standard terms are clear, the design is scientific and reasonable, the operation is convenient and the feasibility is strong. The evaluation results are basically consistent with the actual improvement of patients. It is suggested to add objective evaluation indexes to the scoring method of joint dysfunction index.

Objective Using infrared spectroscopy to analyze three kinds of lignum Chinese medicine to provide a theoretical basis for the establishment of medicinal overall quality evaluation system. Methods Functional groups identification, Fourier Transform-infrared spectroscopy(FT-IR) and the second derivative infrared spectroscopy (SD-IR) could be applicable to analyze and identify the overall chemical composition of three kinds of lignum Chinese medicine. Results The main chemical components of Aquilariae Lignum Resinatum (ALR), Dalbergiae Odoriferae Lignum (DOL) and Sappan Lignum (SL) were cellulose, lignin and aromatics. The main chemical compositions of Sappan Lignum (SL) were cellulose, lignin and aromatics. The differences in FT-IR and SD-IR of DOL and SL indicated that they had different aromatic compounds. Conclusion Infrared spectroscopy can be used as a simple and accurate quality control method of three kinds of lignum Chinese medicine.

Objective:To explore the diagnosis, treatment and curative effect of cervical cellulitis combineing mediastinal pleural abscess. Method:Clinical data of 37 patients with the cervical cellulitis and mediastinal pleural abscess were analyzed, all patients were confirmed using ultrasond, X-ray, CT, puncture and microbiology examination. The result will analysis the diagnosis, treatment and curative effect through the comparison of conservative treatment and surgical treatment. Result:Twenty-three cases of patients were underwent tracheotomy because of difficulty in breathing and successfully extubated after treatment. Nine cases of patients were given anti-infection treatment and recovered after conservative treatment. Twenty-one cases of neck multiple pus cavity were underwent cavity incision, full removal of necrotic tissue and pipe flushing; 7 cases of patients with neck and mediastinal abscess and within which 2 cases were with toxic shock were underwent adequate drainage of lavage and abscess incision through jugular joint path; the companion of pyothorax in 2 cases were underwent the chest closed drainage. All patients were giving sensitive antibiotic after drug sensitive test, anti-shock treatment and supportive treatment. All the patients were recovered and discharged. The average hospitalization days with conservative treatment of these patients were 15.7 days, and the average hospitalization days with surgical treatment of patients were 25.3 days. Conclusion:The condition of cervical cellulitis is complex, a few case can be cured with conservative treatment. The others progress rapidly when merging mediastinal pleural abscess can cause serious complications, surgical treatment is risky, fully abscess incision, lavage drainage and combine with sensitive antibiotics and supportive treatment are the keys to therapy.

Objective To analyze the double contrast-enhanced ultrasonography (DCUS) features of periamupullary carcinoma for enhancing the ultrasound diagnostic value of the disease.Methods The DCUS and clinical data of 40 patients with periampullary carcinoma confirmed by histopathology were reviewed.Results (1) The displaying rate of the lesions and the judgment of lesion location was statistically higher on DCUS than that of ordinary ultrasound (P ＜ 0.05).(2) DCUS features of periampullary carcinoma:the size of most lesions was less than 30 mm except for 1 case in which no lesion was found; In 100％ (39/39) of the lesions,the morphology did not change with duodenum movement ; In 64.1％ (25/39) of lesions hyperenhancement or isoenhancement was displayed in the arterial phase,with low enhancement in the venous phase; In 87.2％ (34/39) of lesions homogeneous enhancement was displayed; In 95％ (38/40) the bile ducts were moderately or severely dilated.The lesion locations and whether the lesions projected into the duodenal cavity or not were statistically different between the three different types of periampullary carcinoma (P ＜ 0.05).The lesions projected into the duodenal cavity of duodenum were more commonly seen in papillary carcinoma and ampullary carcinoma than distal common bile duct carcinoma.The lesion size,whether the lesion morphology changed or not with duodenum movement,enhancement level,enhancement homogeneity,the degree of bile duct dilatation,whether there was pancreatic duct dilatation or not were not statistically different between the three different types of periampullay carcinoma (P ＞ 0.05).Conclusions DCUS is an effective way to show periampullay carcinoma,and is helpful to diagnose periampullary carcinoma and distinguish the three different types of periampullary carcinoma.

The basic medicine teaching must meet the clinical application,while the clinical practice should be timely feedback to basic medical teaching,which is the embodiment of the idea in the translational medicine.The experimental teaching is an important part of modern pathology teaching.We actively improve the experiment course and deepen the basic concept of translational medicine in the medical education development by adopting such approaches as using the problem-based learning method(PBL) to promote the link between basic courses and clinical pathology,integrating and optimizing the teaching content to promote the knowledge mastery and conducting molecular pathology research to promote the implementation of translational medicine.

Objective To investigate the expression and its clinical significance of adisintegrin and metalloprotease-17 (ADAM17) in human glioma.Methods The expressions of ADAM17 in human glioma were detected by immunohistochemical staining.The correlation between ADAM17 expression and the malignance of glioma was analyzed.Results Expression of ADAM17 in human gliomas increased.With the malignant degree,ADAM17 expression has also further increased.However,there was a less ADAM17 expression in normal human brain.The positive expression of ADAM17 in low malignant group was 75％ (18/24),of which 1 case were strong positive.The strong positive expression of ADAM17 was the majority (82.1％,23/28) in malignant group.Conclusion The expression of ADAM-17 was higher in human brain gliomas.With malignance degree increased,of the ADAM-17 expression has gradually increased,suggesting that ADAM-17 might play a certain role in the occurrence and development of glioma.

The student majoring in Medical Biological Technique will be mainly engaged in the practical work of biological technique industry after graduation in the future.In order to bind the theories on the practical biological techniques in designs of contents and roundly improve students' practical ability in classes as well as enriching the communication among students,our college offers an immunologic techniques experiment classes with 36 hours per semester,which has also undergone a reasonable project teaching innovation. This proved to result in a satisfactory outcome in improving the students' practical a

BACKGROUND: There exists insufficient study with specific applicability regarding vascular distribution characteristics of sural nerve nutrient vessels of the distally based flap.OBJECTIVE: To investigate the distribution of sural nerve nutrient vessels of the distally based flap and provide an anatomical evidence for the design of operation on repair of foot injury.DESIGN: A single sample study.SETTING: Research Center of Clinical Anatomy, Fuzhou General Military Hospital of Nanjing Military Area Command of Chinese PLA, and Department of Orthopaedics, the 97 Hospital of Chinese PLA.PARTICIPANTS: Thirty-two samples of lower extremities whose blood vessels were perfused with red emulsion were provided by Research Center of Clinical Anatomy, Fuzhou General Military Hospital of Nanjing Military Area Command of Chinese PLA.METHODS: The origin of the blood vessels of distally based flap and deep communicating branches of the lesser saphenous vein in the samples were dissected and observed.MAIN OUTCOME MEASURES: ①The nutrient vessels of sural nerve of distally basde flap.②The nutrient vessels of lesser saphenous vein of distally based flap.③The superficial and deep communicating branches of lesser saphenous vein of distally based flap.RESULTS: There were 2 to 5 nutrient vessels in the distally based flap:one originating from the perforating branch of the lateral calcaneal artery was (0. 6 ± 0.2) mm in diameter and one from the terminal perforating branch of the peroneal artery was(0.8±0. 2) mm in diameter and they were (1.0 ± 1.3) and(2. 8 ± 1.0) cm, respectively, away from the lateral malleolus. The incidence of intermuscular septum perforating branches (0 to 3) was 96. 7%, 66.7% and 20. 0%, respectively, and their diameter was (0.9 ±0. 3), (1.0 ±0. 2) and (0. 8 ±0. 4) mm and their distance to lateral malleolus was(5.3 ±2. 1), (6. 8 ±2.8) and (7.0 ±4.0) cm, respectively. There were 2 types of nutrient vessels of the lesser saphenous vein of distally based flap, the nutrient vessels of nerve-vein and the ones of vein-nerve. The superficial and deep communicating branches of the lesser saphenous vein were(1.7 ±0. 5) mm in diameter and(3.4 ±0. 9) cm away from the lateral malleolus. They ended at the peroneal veins.CONCLUSION: The perforating branches of heel lateral artery, the terminal perforating branches and intermuscular septum perforating branches of the peroneal artery have sub-branches to deep fascia, skin, nerves and parenteral nutrient vessels. These sub-branches communicate and form vascular chain of lesser saphenous vein to sural nerve and vascular network of superficial and deep fascia. The superficial and deep communicating branches end at the peroneal veins.

Objective To sum up the experiences of early diagnosis and surgical treatment of thoraco abdominal injuries. Method The clinical material in 65 cases of thoraco abdominal injuries treated from 1990 to 1998 was retrospectively reviewed. Result Thoracic explorations and closed thoracic drainage and abdominal operations were carried out in 15 cases and in 50 cases respectively. 65 cases were cured and 3 cases (5%) died of large cardiac blood vessel injuries and excessive blood loss. Conclusion The thoraco abdominal injuries are of very critical illness, it′s important to make early dignosis,promt and proper surgical operation.Meanwhile,active antishock measures, postoperative complication prevention, critical care for the patients are also very important for a better prognosis.