Volume 92  ·   Issue 15  ·  2012

Acute renal injury (AKI) is one of the common complications of abdominal hypertension.The normal intraperitoneal pressure (IAP) in adults is<8 mm Hg (1 mm Hg =0.133 kPa). The World Association for Abdominal Compartment Syndrome defines intraperitoneal pressure above 12 mm Hg as abdominal hypertension (IAH), and abdominal compartment syndrome (ACS) is defined as persistent IAP>20 mm Hg and associated with new organ dysfunction or failure.The incidence of IAH and ACS in ICU is 30% ~54% and 5% ~12%, respectively.The mortality rate of IAH patients in ICU is about 37.9%.The higher IAP, the higher the mortality rate [2]. In critically ill patients, IAP>12 mmHg is an independent risk factor to predict AKI.When AKI occurs, the mortality rate and medical expenses will increase significantly.Therefore, it is of great clinical significance to explore the pathogenesis and treatment principles of abdominal hypertension complicated with AKI.

Objective To explore the effects and mechanisms of heme oxygenase-1 on rats with postresuscitation myocardial dysfunction.Methods Male Sprague-Dawley rats were asphyxiated for 9 minutes and resuscitated.They were randomly divided into 4 groups:sham-operated, cardiopulmonary resuscitation ( CPR ),hemin and hemin + ZnPP ( zinc protoporyphyrin Ⅸ ).Resuscitated groups had 2 observation points:6 and 24 hours post-CPR (n =8 for each time point).And the sham-operated group of 12 rats were divided in two observation points,according to 6 or 24 hours post-operation (n =6 each).Hemodynamic was observed.The expression of heme oxygenase-1 ( HO-1 ) in cardiac tissue was detected by Western blot.And the activity of cardiac homogenate superoxide dismutase (SOD) was determined by xanthineoxidase method and the level of malondialdehyde (MDA) measured by the thiobarbituric acid method.Nitrotyrosine protein expression in cardiac tissuc was analyzcd by immunohistochemistry.Results (1) The mean blood pressure (MAP) significantly decreased in resuscitated groups after resuscitation( all P＜0.05).No difference existed between the subgroups.The scores of dP/dt40 and -dP/dt significantly decreased in CPR and hemin + ZnPP groups after resuscitation ( all P ＜ 0.05 ).But dP/dt40 in hemin group did not differ significantly after resuscitation and - dP/dt decreased only 0.5 hour and 1 hour postresuscitation (3341.60 ± 524.85 and 3711.40 ± 502.39 vs 4284.20 ± 800.87,all P ＜ 0.05 ).The scores of dP/dt40 and - dP/dt in hemin group at all time points post-resuscitation were significantly higher than those in CPR and hemin + ZnPP groups ( all P ＜ 0.05 ).(2) Compared with the sham-operated group,the HO-1 expression,MDA level and nitrotyrosine protein expression significantly increased while the activities of SOD decreased after resuscitation in the CPR,hemin and hemin + ZnPP groups ( all P ＜ 0.05 ).Compared with the CPR and hemin + ZnPP groups,the expression of HO-1 and the activity of SOD increased,while MDA level and nitrotyrosine protein expression were decreased in group hemin( all P ＜ 0.05).No difference existed in the above indices between the CPR and hemin + ZnPP groups.Conclusion HO-1 can reduce myocardial oxidative stress injury after cardiopulmonary resuscitation and effcctively improve post-resuscitation myocardial function in rats.

Objective To assess the therapeutic effect of Xuebijing injection on adult patients with acute respiratory distress syndrome (ARDS).Methods A multicenter prospective randomized control study was conducted at 10 intensive care units in Jiangsu province.A total of 172 early ARDS patients were randomly divided into Xuebijing treatment and control groups.All patients received routine therapy of ARDS while additional Xucbijing injcetion 100 ml was administered in the treatment group intravenously for 7 days.Lung injury score,acute physiology and chronic health evaluation Ⅱ ( APACHE Ⅱ ) score,multiple organ dysfunction score (MODS) and PaO2/FiO2 of the patients was recorded before and after treatment.Mortality at 28 days and the duration of mechanical ventilation were compared between two groups.Results Ninety-one patients were assigned to receive Xuebijing injection and 81 patients as control;Mortality at Days 28 and 90,the duration of mechanical ventilation and ventilation free days showed no difference between two groups (P ＞ 0.05 ).PaO2/FiO2 improved after randomization versus pre-treatment in all patients.There was no significant difference between two groups.Murray scores were not significantly different between two groups.In a subgroup analysis of patients with pulmonary infection, pulmonarycontusion and extra-pulmonary cause,two groups had no difference in mortality at Day 28,mortality at Day 90,the duration of mechanical ventilation,ventilation free days and days of ICU stay (P ＞0.05 ).Conclusion The treatment of Xuebijing injection early in course of ARDS does not improve the mortality of ARDS patients.But it may improve lung function and oxygenation.Further studies are warranted.

Objective To explore the role of left ventricular-arterial coupling in the resuscitation of refractory septic shock.Methods A total of 58 patients with refractory septic shock admitted from January 2010 to July 2011 were retrospectively studied.Hemodynamic data, arterial lactate concentration and APACHE Ⅱ ( acute physiology & chronic health evaluation Ⅱ ) score at the beginning of and 24 hours after cardiac output monitoring,as well as the outcome of Day 28 post-diagnosis were recorded.Stroke volume index (SVI),cardiac index (CI) and global end diastolic volume index (GEDVI) were obtained through transpulmonary thermodilution technique by a pulse induced continuous cardiac output (PiCCO) system.Left ventricular end systolic vnlumne index (IVESVI) was approximated to (GEDVI/4-SVI) while effective arterial elastance index/ventricular end systolic elastance index (Ea Ⅰ/Ees Ⅰ ) was approximated to LVESVI/SVI.Results ( 1 ) APACHE Ⅱ score at the 24th hour,24 hs lactate clearance rate and 24 hs Ea/Ees variation (ΔEa/Ees) were higher in non-survivors than those in survivors; (2) binary Logistic regression analysis showed that ΔEa/Ees and APACHE Ⅱ score at the 24th hour were the independent risk factors of mortality for refractory septic shock.And the OR value of ΔEa/Ees was higher than that of APACHE Ⅱ score (2.04 vs 1.63 ).Their areas of ROC curve were 0.705 (95％ CI 0.569 - 0.841,P =0.007 ) and 0.939 ( 95％ CI 0.878 - 1.000,P =0.000 ) respectively ; ( 3 ) all hemodynamic parameters at the beginning had no difference between ΔEa/Ees ＞ 0 and ΔEa/Ees ≤0 groups.CI,SVI,EGDT (early goaldirected therapy) compliance rate at the 24th hour in the ΔEa/Ees ＞ 0 group were lower than those in the ΔEa/Ees≤0 group.The effective arterial elastance index (Ea Ⅰ ) at the 24th hour and the mortality rate of Day 28 in the ΔEa/Ees ＞0 group were higher than those in the ΔEa/Ees≤0 group; (4) during the 24 hs treatment,ΔEa/Ees was correlated negatively with the variations of CI,SVI,Ees Ⅰ and lactate clearance rate and positively with the variations of heart rate,GEDVI,systolic vascular resistance index and Ea Ⅰ.Conclusion ΔEa/Ees may be used as an excellent marker of predicting the outcome of refractory septic shock.Lowing Ea/Ees in resuscitation has beneficial effects on EGDT compliance,lactate clearance and outcome.

Objective To explore the relatively safe parturition approach of iatrogenic preterm infants.Methods Methods analysis the result of 185 cases Iatrogenic preterm infants come in our hospital from Feb.2007-Jan.2011,divided into two groups by different parturition way:c-section group and vaginal delivery group,to compare the influence of atrogenic preterm infants delivered by different parturition way.Results The c-section group premature infant complication (34.1％,42/123 ) and the mortality rate (9.7％,12/123 ) reduces obviousty compared to the vaginal delivery group ( P ＜ 0.05 ),especially grave asphyxia and intracranial hemorrhage ( P ＜ 0.01 ). Conclusion In inevitable iatrogenic preterm labor,cesarean section may markedly reduce the complications and mortality rate of preterm infants.

Objective To invesligate the clinical characteristics,diagnosis and treatment of Atypical Polypoid Adenomyma of the uterus(APA).Methods A retrospective study was made of 17 patients with APA,who were hospitalized at Peking Union Medical College Hospital from 2003 to 2010.Those patients' clinical characteristics,diagnosis,and treatments are analyzed respectively.The patients ranged from 19 to 53( median 39 )years old,Most of them (15/17) are during child-bearing period.There was one patient with infertility,two of the patients were postmenopausal. Results Fourteen cases had irregular vaginal bleeding clinically. Most of the pathology were polypous,which is more than 1 cm. Fifteen cases were characteristically polypoid,among which there were one case with multipolypoid and onc casc was extensive.Eight cases were located in the uterine cavity.Six cases were located in the lower uterine segment.Three cases were located in cervix.None of the cases were dignosed,while all of them were dignosed by pathology after primary surgical.Fifteen patients had polypectomy ( among them,five patients took drug therapy after the surgical),while the remaining two patients had hysterectomy.Two of the five patients,who took drug therapy, were pregnant. One patient was deteriorated with carcinoma of endometrium. Conclusion Although most cases of APA were begine,a few cases were associated with low malignant potential of recurrence.The treatment should depend on the age and reproductive desire of patient.And long-term followup is suggested.

Objective To evaluate the clinical efficacies of botulinum toxin type A ( BTX-A ) injection under ultrasonic guidance and body surface positioning in poststroke patients with lower extremities spasticity.Methods From January 2009 to January 2011,a total of 18 patients with stroke-related spasticity in lower extremities were recruited at Third Affiliated Hospital of Sun Yat-sen University.Under the guide of color Doppler ultrasound and body surface positioning,BTX-A was injected into multi-points of muscles.The outcome after BTX-A injection was assessed by modified Ashworth scale ( MAS ),passive range of movement ( PROM),10-meter walking test ( 10 MWT) and Berg balance scale (BBS).Assessments were performed at baseline,Day 3,Weeks 1,2,4 and 12 post-injection respectively.Results Compared the scores of MAS ( MASpre-treatment 2.6 ± 0.5,MASpre-treatment 1.9 ± 0.2 - 1.1 ± 0.3 score),PROM ( PROMpre-treatment 7.2 ± 2.4～,PROMpost-treatment 12.3 ±2.0- 18.6 ± 2.2°) between baseline and follow-up at Weeks 1,2,4 and 12 postt reatment,there were significant statistical differences (P ＜ 0.05 ).10 MW (10 MWTpre-treatment 55.1 ± 5.2 s,10 MWTpre-treatment 48.6 ±4.2 42.9 ±3.8 s) and BBS (BBSpre-treatment 34.7 ±5.1,BBSpre-treatment 39.9 ±4.9 -45.8 ± 2.1 score) improved greatly at Weeks 2,4 and 12 post-treatment.Conclusion Ultrasonic guidance and body surface positioning is an accurate positioning modality of using BTX-A for treating the spasticity of lower extremities.

Objective To summarize the clinical efficacies and experiences of using rapid pore cranial drilling and external ventricular drainage (EVD) in the treatment of ventricular hemorrhage caused by thalamic hemorrhage.Methods Retrospective analysis was conducted for 401 patients at 5 hospitals from May 1983 to December 2010.Thcy undcrwent EVD with an infusion of urokinase for intraventricular hemorrhage caused by thalamic hemorrhage.There were 212 males and 189 females with an age range of 19 -78 years.Results After a l-month therapy,the outcomes were cure 147/401 (36.7％),improvement 192/401 (47.9％) and others ( death and against-advice discharge) 62/401 ( 15.4％ ).After 1 - 3-month treatment,their prognoses were evaluated by activity of daily living (ADL):ADL Ⅰ 147/401,ADL Ⅱ 82/401,ADLⅢ 76/401,ADLⅣ 19/401,ADLV 15/401,death 43/401 and against-advice discharge 19/401.During a follow-up period of 1 -3 years,274 patients showed the following outcomes:ADL Ⅰ 122/243,ADL Ⅱ 63/243,ADL Ⅲ 58/243 while 31 patients died from pulmonary infection.Conclusion The procedure of EVD (including an infusion of urokinase) with rapid pore cranial drilling is preferred treatment for ventricular hemorrhage caused by thalamic hemorrhage.

Objective To explore the surgical techniques and efficacies of deep brain stimulation (DBS) in the trcatment of the patients with essential tremor (ET).Methods A total of 6 ET patients from January 2004 to June 2011 at Department of Neurosurgery,Beijing Tiantan Hospital were recruited to rcccive DBS at ventral intermediate nucleus of thalamus (Vim-DBS) (n =5 ) and subthalamic nucleus (STN-DBS) (n =1 ).All underwent stereotactically guided DBS procedures utilizing atlas of neuroanatomy and neurophysiology,pre-operative magnetic resonance imaging (MRJ),microelectrode recording and intraoperative testing for target-locating.Postoperative computed tomography (CT) and/or MRI scan were performed after implantation.Such stimulation parameters as stimulus voltage,frequency,pulse width and polarity configuration were adjusted postoperatively to optimize tremor control and maximize battery life.The patients werc followed by further consultations or telephone for a comprehensive evaluation of their therapeutic efficacies.Results All patients showed typical electrical signal and relief of tremor symptoms with significant tremor control.No severe advcrse events,such as infection,hemorrhage,paresthesia,dysarthria, cognitive deficits, imbalance and diplopia, appeared after the implantation of DBS electrodes.Conclusion Vim-DBS and STN-DBS are both safe and effective for the controls of unilateral and bilateral tremors.

Objective To explore the brain regions associated with impulsive decision-making behaviors and interpret the nervous mechanism for addiction and relapse in heroin abusers.Methods Using the paradigms of psychological experiment,the subjects in both heroin addiction group ( HA group) and normal control group (HC group) performed Iowa gambling task (IGT)and simultaneously underwent functional magnetic resonance imaging (fMRI) scan.All the above data were gathered and then analyzed by SPM5 software to explore both the brain regions and their functional changes correlated with impulsive decision-making.Results Evidence by IGT behavioral consequences demonstrated that the net scores in HC group increased with numbers of decision-making whereas no increment (fluctuating between - 1 and 0) was observed in HA group.Based on the results of fMRI analysis,right orbitofrontal cortex (OFC),dorsolateral prefrontal cortex (DLPFC),left ventromedial prefrontal cortex (MPFC) and anterior cingulate cortex (ACC) were activated in both groups.But the right OFC was more active while the right DLPFC and left MPFC were weaker in HA group versus the HC group.Meanwhile,activation of right lenticular nucleus,right thalamus,right insula,hippocampus and left caudate nucleus were obscrvcd in HA group. Conclusion Heroin abusers are incapable of impulsive decision-making in behavioral studies.Such a brain region as prefrontal cortex participates in the decision-making performance and control of impulsiveness.Functionally abnormal brain regions correlated with impulsive decision-making may be one cause of genesis,maintenance and relapse of heroin addiction.

Objective To evaluate the safety and validity of neo-adjuvant chemoradiotherapy followed by surgery for locally advanced esophageal carcinoma.Methods Patients with Ⅱ B,Ⅲ staged squamous cell carcinoma of thoracic esophagus were randomly allocated to either preoperative chemoradiotherapy followed by surgery ( arm A ) or surgery alone ( arm B ).In arm A,chemotherapy and radiotherapy were performed concurrently.Patients received two cycles of vinorelbine and cisplatin.Vinorelbine at 25 mg/m2 per day was administered as a bolus infusion at dl,d8,d22 and d29.Cisplatin at 75 mg/m2 was administered by an intravenous infusion at dl and d22( or 25 mg/m2 days 1 - 4 and 22 - 25 ).A total radiotherapeutic dose of 40 Gy was delivered in 20 daily fractions of 2.0 Gy each (5 d/wk for 4 weeks ).Three-incisioned esophagectomy was performed at Weeks 4 - 6 after chemoradiotherapy.Primary outcome was overall survival time.An interim analysis was performed in June 2011.Results From July 2007 to June 2011,123 eligible patients were randomly assigned at 7 cooperative cancer centers (54 cases in arm A vs 69 cases in arm B).In arm A,the clinical response rate of chemoradiotherapy was 90.7％.All patients finished the preoperative chemoradiotherapy. Forty-nine cases continued to receive esophagectomy.The pathological complete response rate was 29.6％.The rate of RO resection in arm A was significant higher than that in arm B (96.0％ vs 85.5％,P =0.015 ).The most common grade 3/4 toxicity of chemoradiotherapy was leukopenia occurring in 33 cases (61.l％ ).Vomiting and esophagitis were usually of Grade 1/2.No patient died or abandoned surgery because of chemoradiation toxicity.Between arms A and B,operative duration,blood loss,duration of chest tube drainage and length of postsurgical hospital stay were similar.The incidences of postoperative heart failure (2.0％ vs 1.4％,P =1.000),anastomotic leakage(8.2％ vs 11.6％,P =0.759)and hoarseness(6.1％ vs 4.3％,P =0.691 )were not significantly different.The incidence of pulmonary infection in arm A was slightly higher than that in arm B (8.2％ vs 1.4％,P=0.094).No perioperative deaths occurred in either group.There were no significant differences in overall survivals at 1,2 years between arms A and B(85.6％/75.5％ vs 79.1％/66.1％,P =0.207).The disease-free survivals at 1,2 years in arm A were slightly higher than in arm B (86.6％/83.2％ vs 70.9％/61.8％,P =0.075 ).Conclusion Neo-adjuvant chemoradiation followed by surgery may achieve a high clinical response rate and pathologic complete tumor regression rate.It significantly increases the RO resection rate and downstage the esophageal cancer patients.But its ultimate efficacy awaits further follow-up studies.

Objective To explore the therapeutic effects of atropine for hypoxic bradycardia during the occurrence of cardiac arrest.Methods Sixty-four adult New Zealand rabbits were selected and allocated randomly into 2 groups: instant resuscitation group and 8-minute resuscitation group.Each animal was anesthetized by an intravenous injection of sodium pentobarbital and intubated through treacheostomy.The racheostomy tube was then clamped off to induce acute hypoxia.At soon as heart rate (HR) decreased to a half of basic-heart-rate,either atropine 50 μg/kg or 0.9％ normal saline as control was randomly administered intravenously.In instant resuscitation group (group T1 ),the tracheostomy tube was unclamped and cardiopulmonary resuscitation (CPR) initiated for the occurrence of cardiac arrest ( MAP ＜ 10 mm Hg).In 8-minute resuscitation group ( group T2),the tracheostomy tube was clamped for 8 minutes and then CPR initiated.The statistical data were analyzed by SPSS 10.0.All data were reported as (x) ± s.T test was used to compare the means of cardiac arrest time between two groups,one-way ANONA to compare HR & mean arterial pressure (MAP) and Fisher's exact probabilities test to compare the survival rates between two groups.A value of P ＜ 0.05 was considered statistically significant.Results The heart rate of atropine treated group was higher than that of normal saline group for about 90 minutes post-dosing. In atropine group,the MAP decrease was significantly faster than that of normal saline group ( P ＜ 0.01 ).Most importantly,after the clamping of tracheostomy tube,the average time of cardiac arrest occurred at (335.43 ±43.25)s in atropine group versus (371 ± 55 ) s in normal saline group (P=0.006).Conclusion Although atropine treatment of severe hypoxic bradycardia improves the decrease of HR for a short time,it decreases MAP and accelerates the occurrence of cardiac arrest result from acute hypoxia.But the mortality rate is not improved by the treatment of atropine.

Objective To invcstigatc the feasibility and safety of catheterization in rat hepatic artery and interventional therapy through carotid artery.Methods A total of 30 Sprague-Dawley rats were randomly divided into 2 groups.All were punctured through left common carotid artcry (LCCA) under intraperitoneal injection anesthesia.Microcatheter was inserted through a puncturing outer cannula into celiac artery and angiography performed to investigated the anatomical structure.Then a microcathctcr was insertcd into proper hepatic artery.One group was perfused with epirubicin 5 mg while another embolized with lipidol and polyvinyl (PVA).The status of vascular patency was re-examined by celiac angiography after perfusion and embolization.The 2-week survival rate (SR) and related complications were observed.Results Except for one failed case,all other cases were successfully inserted and celiogastroduodenal arteriography was completed with a success rate of 97％ (29/30).The anastomosis between gastroduodenal artery (GDA) and superior mesenteric artery (SMA) was demonstrated in 28 cases (28/29,96.6％).In 14 cases with perfusion therapy,artcriography demonstrated all branches of celiac artery had no occlusion while 10 embolized cases ( 10/15,67％ ) had the main branch occlusion of gastroduodenal artery and 5 (5/15,33％ ) stayed open.No postoperative abnormality was found in thc limb motor function.Fivc had the drooping of left upper eyelid during 12 -24 h after intervention and subsided after a week.And 10 embolized via main branch of gastroduodenal artery showed a poor appetite within 3 days postoperation and recovered gradually after 3 days.After intervention,27 rats survived in 2 weeks.The survival rate was 93％ (27/29).One died of incision infection and another neck hematoma.Conclusion Catheterization in hepatic artery and interventional therapy through carotid artery is both feasible and safe.It may have a high application value.

Objective To detect the expression of IGF- Ⅰ receptor in the hippocampus neuron of rat treated by Aβ1-42,and thus from the receptor level explore the disorder of central nervous insulin signaling and the possible molecular mechanism of Alzheimer disease.Methods Cultured primary hippocampus neurons were treated with different concentrations of Aβ1-42,apoptosis rate was detected by flow cytometry,real-time quantitative PCR and Western blot were used to detect IGF-Ⅰ receptor expression. Results Primary cultured cells mature in 7th days; after detected by flow cytometry,early apoptosis rate in Aβ1-42 O,30,60,100 μmol/L groups showed a concentration-dependent increase.PCR results showed that,in 30 ( 1.72 ± 0.33 ) and 60 μmol/L ( 1.86 ± 0.36 ) treatment groups levels of the IGF- Ⅰ receptor gene were significantly higher than the control group (regarded as 1 ) (P ＜ 0.01 ),100 μmol/L group (0.70 ± 0.15 )was significantly lower than the control group ( P ＜ 0.05 ).Results of Western blot showed 30 and 60 μmol/Lprotein level of the treatment groups are 1.08 ± 0.04,1.74 ± 0.08 ( P ＜ 0.01 ) and 100 μmol/L group was 0.79 ± 0.11 (P ＜ 0.05 ),which had same trend with PCR.Conclusions Aβ1-42 induced altered expression of IGF- Ⅰ receptors in rat hippocampus cells,maybe one of the molecule mechanisms of Alzheimer disease.

Objective To observe the altered expressions of neuropeptide Y,substance P and vasoactive intestinal peptide in detrusor of SD rats after spinal cord injury and explore the relationship of the above neuropeptides and neurogcnic bladder after spinc cord injury.Methods Twenty male clean-grade SD rats,aged 6 weeks,were selected and randomized into spinal cord injury group (n =10) and control group (n =10).Rats in spinal cord injury group were smashed at T10 to cause spinal cord incomplete injury model by the weight drop method while laminectomy alone without smashing was administered in control group.At Week 1 post-operation,all rats were assessed by the maximum bladder capacity,bladder compliance and detrusor pressure for the confirmation of spastic bladder.And all detrusor specimens were marked with argentation and immunohistochemistry for the analyses of nerve fibers,neuropeptide Y,substance P and vasoactive intestinal peptide.The results were evaluated with semiquantitative method to observe the contents of nerve fiber and neuropeptides.Results At Week 1 post-operation, the mean maximum bladder compacity,mean maximum detrusor pressure and mean compliance in SCI rats was 0.71 ± 0.24 ml,32.27 ±3.12 cm H2O and 0.020 ±0.009 ml/cm H2O versus 2.0 ± 0.4 ml,21.0 ± 3.0 cm H2O and 0.090 ± 0.020 ml/cm H2O in normal control group respectively.And the differences were statistically significant (P＜0.01).Meanwhile,the mean content of nerve fibers of neurogenic bladder decreased markedly than that of normal control group ( 2.58 ± 0.1 3 vs 5.65 ± 0.26 ).As compared with the normal control group,the expressions of neuropeptide Y,substance P and vasoactive intestinal peptide (mean integrated optical density:3.2 ± 0.5,1.7 ± 0.4 and 2.1 ± 0.4 respectively) decreased dramatically in SCI rats.And the differences were statistically significant ( P ＜ 0.01 ),Conclusion The number of nerve fibers and the content of neuropeptides significantly decrease in neurogenic bladder after spinal cord injury in rats.The reduction of neuropeptides may be correlated with the formation of neurogenic bladder after spinal cord injury.

Objective To fabricate porous biodegradable lissue engineered vein containing valve scaffolds.Methods Based on the self-made cast,the tissue engineered vein containing valve scaffolds was fabricated by injection molding plus thermally induced phase separation.Poly ( lactic-co-glycolic acid ) (PLGA,LA/CA mole ratio 75∶25 ) was used as matrices.Morphological structures and biocompatibility of scaffolds were tested.Cell seeding on scaffold was performed and the mechanic characteristics of cellular constructs evaluated.Results The scaffold had an inner diameter of 9 mm with a wall thickness of 0.9 mm and the thickness of valves was ( 0.32 ± 0.04 ) mm.Scanning electron microscopic ( SEM ) micrographs showed regular ladder-like porous structures and the average pore size and porosity of scaffolds were 10 20 μm and 90％.The PLGA scaffolds were biocompatible.The cellular constructs were tested in titro,and the valve leaflets were functionally capable of opening and closing when stimulated.Conclusion Bascd on the self-made cast,the tissue engineered vein containing valve scaffolds can be fabricated by injection molding plus thermally induced phase separation.Further researches are warranted.

Medical Record Abstract A 45-year-old female was admitted to the First Affiliated Hospital of Zhengzhou University on January 20, 2011 due to intermittent dizziness and headache for 21 months and blurred vision in her left eye for more than 8 months. In mid-April 2009, she developed dizziness without obvious trigger, intermittent pain in the left temporal region without radioactivity, occasionally accompanied by nausea, non-jet vomiting of stomach contents, and the amount was not large. The above symptoms were repeated and improved by self-administration of traditional Chinese medicine. From March to May 2010, the above symptoms gradually worsened, occasionally with double vision, soreness in the left eye, drooping eyelids, obvious convexity of the eyeball, and fixation and inability to move, so she went to the ophthalmology clinic of the First Affiliated Hospital of Zhengzhou University and was diagnosed with binocular papilla edema.

CA125 is a cancer antigen expressed by epithelial ovarian cancer cells discovered in the 1970s. It has been used as a tumor marker in clinical practice of ovarian cancer for more than 30 years. Serum CA125 assay was initially used for the diagnosis of epithelial ovarian cancer, and then its application scope was extended to the evaluation of treatment response, prognosis assessment, recurrence monitoring and screening, etc. With the deepening of research in recent years, CA125 is changing from a simple marker to a target for treatment.

Case 1: An 11-year-old female was admitted to the Department of Obstetrics and Gynecology of Tianjin Medical University General Hospital for the first time in October 2006 due to sudden right lower abdominal pain accompanied by nausea and vomiting for 1d. Physical examination: height 115 cm, weight 25 kg, undeveloped breast, soft abdomen, obvious tenderness in right lower abdomen, no rebound pain; Anal examination: young female vulva, no pubic hair, uterus size matched with age, cystic mass palpable in the right adnexal area, about 6 cm in diameter, clear border, obvious tenderness, limited movement, aggravated pain when pushing, thickening in the left adnexal area, no tenderness; There was no edema in the lower limbs. B-ultrasound showed that the uterus was of normal size, and both ovaries were obviously enlarged, showing multi-vesicle shape. Figure 1. The patient had full-term birth, with retarded growth and development from the age of 7 to 8 years old, and his intelligence was slightly lower than that of his peers. He had menarche one month before admission.