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Objective@#To investigate the incidence rate of transjugular intrahepatic portosystemic shunt (TIPS) complications in the treatment of cirrhotic portal hypertension, and analyze the cause of complication to management methods.@*Methods@#Data of 116 patients obtained from Zhongnan Hospital of Wuhan University were retrospectively analyzed. Portal venous pressure, routine blood test, coagulation test, liver and kidney function test, ammonia blood test, imaging and endoscopy reports were collected before and after procedure. The incidence rate of hepatic encephalopathy, gastrointestinal bleeding, ascites and shunt dysfunctions were observed. Data were expressed as mean ± Standard deviation and analyzed by t-test. A chi-squared test was used for comparison between categorical variables.@*Results@#The success rate of TIPS operation was 97.41% (113/116). Two patients underwent prompt TIPS procedure due to active bleeding. Bleeding was successfully stopped. Portal venous pressure of 113 patients decreased from (42.73 ± 7.64) cmH2O to (24.92 ± 7.60) cmH2O, and the difference was statistically significant (P < 0.01). Twenty cases were of hepatic encephalopathy. Preoperative level of Child-pugh class C patients was more susceptible to hepatic encephalopathy within 3 months after procedure than class A and B. After TIPS procedure, there were 22 cases of gastrointestinal bleeding, 18 cases of shunt dysfunctions and 26 cases of disease related death.@*Conclusion@#Rational patient selection strategies can effectively reduce portal venous pressure, incidence of hepatic encephalopathy, improve mid-and long-term therapeutic effects, and provide opportunities for liver transplantation.
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BACKGROUND:Transfusion guidelines pointed out:whole blood should be stored at (4±2)℃. The bacterial growth or loss of function should occur if the blood leaves the suitable storage conditions. Recipients wil suffer from different degrees of blood transfusion reaction or invalid infusion. OBJECTIVE:To observe morphology of erythrocytes of autologous blood stored at different temperatures using microscope. METHODS:Blood was obtained from 40 cases of acute normovolemic hemodilution and stored in ACD citrate bags. Whole blood was respectively stored at 4 ℃ and 23 ℃. Blood smear was taken respectively in the blood storage immediately, 1, 2, 3, 4, 5 and 6 hours after col ecting autologous blood. Changes in morphology of erythrocytes were observed with a microscope. Deformity rate of erythrocytes was calculated. Six blood samples were randomly selected to test pH, K+, and free hemoglobin respectively in 6-hour common temperature group and ACD banked blood within the valid period. Six blood samples were randomly selected for the bacterial culture in each group of two groups at 6 hours. RESULTS AND CONCLUSION:There were no significant differences in abnormality rates of erythrocytes between 4 ℃ and common temperature groups at each time point. The pH, K+, free hemoglobin at six hours in the common temperature group were better than those of ACD banked blood within the valid period and there was no bacterial growth in culture between the two groups. Therefore, it is feasible to transfuse autologous blood back to the patient within 6 hours of storage at room temperature.
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Objective To explore the expression change of intestinal epithelial tight junction (IJ)protein claudin-1 in mice with fulminant hepatic failure (FHF).Methods FHF was induced with a method that combined intraperitoneal injection of lipopolysaccharide (LPS,10 mg/kg) and D-galactosamine (GalN,800 mg/kg).Control saline (2 ml/kg,ip),LPS (10 mg/kg,ip) and GaIN (800 mg/kg,ip) were also detected.The effect of administration of anti-tumor necrosis factor alpha (TNF-α) IgG antibody (anti-TNF-α IgG,100 μg/per) on the level of TNF-α was assessed before administration of D-galactosamine/lipopolysaccharide.At the 2nd h,6th h,9th h,12th h,24th h after injection in FHF group,the 9th h after injection in control groups and 9th h after injection in anti-TNF-α IgG group,the mice were killed for the collection of large intestine specimens.Claudin-1 was analyzed with immunohistochemistry,Western blotting,and real-time quantitative PCR.Results Tight junction protein claudin-1 was localized along the apical region of the lateral plasma membrane representing the region of tight junctions in surface and crypt epithelial cells.Weakly distributed density of claudin-1 in intestinal mucosa was found in mice with FHF from the 9th h after injection.Compared to saline group,Western blotting analysis demonstrated markedly reduced claudin-1 expression in mice with FHF at the 6th h and 9th h after injection (6th h:0.8600±0.0208 vs 1.0,P ＜0.05; 9th h:0.6633 ±0.0328 vs 1.0,P ＜0.01).Furthermore,the expression of claudin-1 mRNA was markedly reduced at the 6th h,9th h,and 12th h after injection in mice with FHF (6th h:0.3067 ±0.1291 vs 1.0,P ＜0.05; 9th h:0.2233 ±0.1155 vs 1.0,P ＜0.01 ; 12th h:0.5275 ±0.1222 vs 1.0,P ＜0.05).Compared to saline group,no significant difference in claudin-1 expression was found with prophylactic treatment with anti-TNF-α-IgG antibody in mice with FHF at the 9th h after injection (protein:0.9533 ±0.0186 vs 1.0,P ＞0.05; mRNA:0.85 ±0.1437 vs 1.0,P ＞0.05).Conclusions The expression of tight junction protein claudin-1 was reduced at both protein and mRNA levels in intestinal epithelial cells that were induced by TNF-α in mice model of FHF.
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ObjectiveTo investigate the effects of eyes-closed (EC) and eyes-open (EO) EEG field powers on the auditory P300 evoke potentials.MethodsThe EEG was recorded in 12 healthy male college students (20 ～24 years) respectively in their eyes-closed and eyes-open states,and then the auditory P300 paradigm was performed.Results① Alpha band was distributed at the posterior-occipital area,while Alpha-1 (7.5～9.5 Hz) field power were EC as (2.62 ±0.81 ) μV2 and EO as ( 1.80 ±0.56) μV2,with statistical significance (P ＜ 0.01 ) ; Alpha-2 ( 10 ～ 12 Hz) field power were EC as ( 8.55 ± 1.85 ) μV2 and EO as (4.95 ± 1.59 )μV2,also with statistical significance (P＜0.05).②In P300,the Common stimulus elicited clear component N1 (90ms)and P2 (180ms) in the ERPs after stimulus,while there were no significant differences between EC and EO states.Correspondingly,the rare stimulus elicited clear component N2 (207 ms) and P3 (313 ms) in the ERPs after stimulus on-set.Comparing the differences of field potentials of the rare stimulus between the two states,N2field potential in EC ( (0.01 ± 0.71 ) μV) was smaller than that in EO ( ( - 2.13 ± 0.80 ) μV ),with statistical significance (P ＜ 0.05 ) ; while P3 field potential in the EC ( ( 4.16 ± 1.08 ) μV ) was smaller than that in EO ( (4.78 ± 1.20) μV),but without statistical significance (P ＞ 0.05 ).ConclusionThe alpha field power is higher in eyes-closed than in eyes-open state,while performing the same auditory P300 paradigm,significant reduction of field potential in the N2 component are observed in eyes-closed than in eyes-open state.
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Objective To investigate the gender differences and the effect of three factors(the angle of rotation, left/right,palm/back) on hand mental rotation. Methods 40 healthy adults (20 males and 20 females, age; 18～26 years) were enrolled in this study. By simulation of human hand as picture stimuli,participants were instructed to decide as quickly as possible whether the stimulus was a left or right hand. The accuracy rate and reaction time of the behavior task were quantified. Results ① the subjects' reaction speed was far slower at 180° than 0°(P＜0.01). ②On judgment of 0° back picture,females were faster than males(left back: males( 1033. 16 ±245.85) ms,females( 853.15 ± 142.79) ms,P=0.014; right back; males( 973.07 ±217.11) ms;,females (796.28 ±146.67 )ms, P = 0.016). And,the right hand was responded faster than left hand,with statistical significance (males; P = 0.028, females; P=0.038). ③The time of females in judging the 0° hand back ( left (853. 15 ± 142.79) ms,right (796. 27 ± 146. 67 ms) ) was shorter than palm(left ( 1002. 72 ± 227. 91) ms,right ( 986.06 ± 230. 03) ms), reached statistical significance ( both at P ＜ 0. 001). In contrast, males in judging the 180° pictures, the speed of reaction to back(left ( 1252. 70 ±269. 35) ms,right ( 1216. 68 ±293. 54 )ms) was slower than palm with statistical significance (left: P ＜ 0. 01, right: P = 0. 015). Conclusion The three factors (angle of rotation,left/right,and palm/back) all exert effect on the behavior of hand mental rotation. It really has gender difference on hand mental rotation. Females response faster than males.
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<p><b>OBJECTIVE</b>To investigate the variation in movement traces of different condylar reference points.</p><p><b>METHODS</b>In 30 healthy subjects, mandibular movements were recorded during protrusion and open-closing of the jaw. The kinematic center and terminal hinge axis point of the condyle were used as reference points.</p><p><b>RESULTS</b>The kinematic center was located anteriorly and superiorly with respect to the terminal hinge axis point. The trace distance of the kinematic center was longer than that of the terminal hinge axis point of the condyle during opening. In contrast to differences in trace distances of the left and right condylar terminal hinge axis points, no such left-right differences were found for the kinematic centers. The ratio between the distance of opening trace and the distance of protrusion trace of the kinematic center was above 1.5.</p><p><b>CONCLUSIONS</b>In comparison to the terminal hinge axis, the kinematic center shows fewer variations in the movement traces.</p>
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Adult , Humans , Biomechanical Phenomena , Jaw , Physiology , Mandibular Condyle , Physiology , MovementABSTRACT
<p><b>OBJECTIVE</b>To study the influence of different shape of lower jaw on stress distribution at bone interface in the mandibular molar region of implant restoration models.</p><p><b>METHODS</b>Six models with different lower jaw shapes were constructed by using three-dimensional finite element method. Implant-bone interface stresses in these models were studied under vertical and lateral loads.</p><p><b>RESULTS</b>No matter in the condition of vertical loading of lateral loading, stress distribution patterns were similar in variant models and differences of stress values were not statistically significant. The maximal differences in Von-Mises stress, compressive stress and tensile stress among the six models were 6.4%, 2.8% and 6.2%respectively.</p><p><b>CONCLUSION</b>It is rational to simplify the lower jaw shape in finite element analysis.</p>
Subject(s)
Female , Humans , Male , Dental Implantation , Models, Dental , Dental Prosthesis Design , Methods , Dental Stress Analysis , Methods , Finite Element Analysis , MandibleABSTRACT
Objective To explore the differential diagnosis among lacunas, demyelination and perivessel space in the aging brain. Methods T1 and T2 weighted image for 100 aging brains were analyzed retrospectively. All examinations were performed using GE 1.5 T scanner. Results In 100 subjects, 61 had multiloci of infarction and constituted a total of 110 loci. They located at pontine(17), cerebellum(14), lentiform nucleus(24), internal capsal(10), thalamus(12), periventricular and head of caudate nucleus (26), semioval centrum (7). They were round, elliptic, triangle, curve and irregular in shape, respectively. Ninety-five patients had 125 countable perivessel spaces. They located at ganglia (84) and semioval centrum (41). Demyelination was seen in 71 subjects and involved pontine and semioval centrum. Conclusions Most of lacuna, demyelination and perivessel space is distinguishable based on their signal, shape and location.
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Objective To retrospectively analyze the complications and management of complications during percutaneous implementation of biliary stents in 17 patients. Methods Percutaneous biliary drainage and implementation of biliary stents for malignant biliary obstruction under fluoroscopic guidance was performed in 64 patients. 17 cases developed complications. Bradycardia and hypotension was seen in 5 cases, slipping of the stent into the duodenum in 1, bile duct perforation in 2, the fine guidewire broken in the hepatic parenchyma in 2, malposition of the stent in 3, hepato renal failure leading to hemorrhage in 2, exchanging guidewire broken in the duodenum in 1, and balloon broken leading to stent dislocation in 1, respectively. Results Bradycardia and hypotension in the 5 cases was treated medically and the procedure was interrupted. Slipping of the stent into the duodenum was passed off spontaneously. Broken of the fine guidewire in the liver did not present any complaints until the death of the patients. Perforation of bile duct was treated conservatively with a clinical successful outcome. Malposition of the stent was treated by reimplementation of shorter stents. The broken exchanging guidewire in the duodenum during implementation was removed with the gastroscope. The hepato renal failure leading to hemorrhage had poor prognosis. The broken balloon caused stent dislocation was treated by reimplementation of stent. Conclusion Percutaneous implementation of stent is effective and safe for elderly patients with proximal stenosis of the biliary tract. However, one must be very careful to avoid the complications.