Sclerosing cholangitis secondary to bleomycin-iodinated embolization for liver hemangioma

Sclerosing cholangitis(SC)is a rarely reported morbidity secondary to transcatheter arterial chemoembolization(TACE)with bleomycin-iodinated oil(BIO)for liver cavernous hemangioma(LCH).This report retrospectively evaluated the diagnostic and therapeutic course of a patient with LDH who presented obstructive jaundice 6 years after TACE with BIO.Preoperative imaging identified a suspected malignant biliary stricture located at the convergence of the left and right hepatic ducts.Operative exploration demonstrated a full-thickness sclerosis of the hilar bile duct with right hepatic duct stricture and right lobe atrophy.Radical hepatic hilar resection with right-side hemihepatectomy and Roux-en-Y hepaticojejunostomy was performed because hilar cancer could not be excluded on frozen biopsy.Pathological results showed chronic pyogenic inflammation of the common and right hepatic ducts with SC in the portal area.Secondary SC is a long-term complication that may occur in LCH patients after TACE with BIO and must be differentiated from hilar malignancy.Hepatic duct plasty is a definitive but technically challenging treatment modality for secondary SC.

ANTI-HYPOXIA AND ANTI-OXIDATION EFFECTS OF AMINOPHYLLINE ON HUMAN WITH ACUTE HIGH-ALTITUDE EXPOSURE

Objective To investigate the anti-hypoxia and anti-oxidation effects of aminophylline on human with acute high- altitude exposure. Mothoda Totally 100 young male army members newly recruited from Sichuan province （400 meters above sea level） were enrolled. They were randomly divided into two groups： 50 in aminophylline group （A group） and 50 in control group （ C group）. A group and C group orally took aminophylline and placebo respectively for 10 days, 7 days before entering Lhasa （3 658 meters above sea level） by air and 3 days after it. Several parameters were measured at three time points： before drug taken, 7 days after drug taken, and 3 days after ascending high altitude. These parameters included serum levels of nitric oxide （NO）, superoxide dismutase （SOD）, catalase （CAT）, hydrogen dioxide （H2O2）, lactic acid （LA）, as well as arterial oxygen saturation （SO2）, arterial oxygen partial pressure （PaO2）, and arterial carbon dioxide partial pressure （PaCO2）. Statistical analysis was conducted to compare the difference between two groups with Stata 7.0 software system. Results There were no statistical differences between groups in hypoxia and oxidation indicators before and after drug taken in plain area. Three days after ascending high altitude, the serum levels of SOD, CAT, H202, LA, PaCO2 increased in both groups, yet to a much larger degree in C group than A group （P 〈0. 01 ） ; and NO, SO2 , PaO2 decreased more markedly in C group （ P 〈 0. 05 for NO, P 〈 0. 0001 for SO2 and PaO2 ）. Conclusion Aminophylline has significant anti-hypoxia and anti-oxidation effects at high altitude.

Drainage fluid and serum amylase levels accurately predict development of postoperative pancreatic fistula

AIM To investigate potential biomarkers for predicting postoperative pancreatic fistula( POPF) after pancreaticoduodenectomy(PD).METHODS We prospectively recruited 83 patients to this study. All patients underwent PD(Child's procedure) at the Division of Hepatobiliary and Pancreas Surgery at the First Bethune Hospital of Jilin University between June 2011 and April 2015. Data pertaining to demographic variables, clinical characteristics, texture of pancreas, surgical approach, histopathological results, white blood cell count, amylase and choline levels in the serum, pancreatic/gastric drainage fluid, and choline and amylase levels in abdominal drainage fluid were included in the analysis. Potential correlations between these parameters and postoperative complications such as, POPF, acute pancreatitis, hemorrhage, delayed gastric emptying, and biliary fistula, were assessed. RESULTS Twenty-eight out of the 83(33.7%) patients developed POPF. The severity of POPF was classified as Grade A in 8(28%) patients, grade B in 16(58%), and grade C in4(14%), according to the pancreatic fistula criteria. On univariate and multivariate logistic regression analyses, higher amylase level in the abdominal drainage fluid on postoperative day(POD)1 and higher serum amylase levels on POD4 showed a significant correlation with POPF(P < 0.05). On receiver operating characteristic curve analysis, amylase cut-off level of 2365.5 U/L in the abdominal drainage fluid was associated with a 78.6% sensitivity and 80% specificity [area under the curve(AUC): 0.844; P = 0.009]. A cut-off serum amylase level of 44.2 U/L was associated with a 78.6% sensitivity and 70.9% specificity(AUC: 0.784; P = 0.05).CONCLUSION Amylase level in the abdominal drainage fluid on POD1 and serum amylase level on POD4 represent novel biomarkers associated with POPF development.

Potentially fatal electrolyte imbalance caused by severe hydrofluoric acid burns combined with inhalation injury: A case report

BACKGROUND Hydrofluoric acid(HF)is one of the most common causes of chemical burns.HF burns can cause wounds that deepen and progress aggressively.As a result,HF burns are often severe even if they involve a small area of the skin.Published cases of HF burns have mostly reported small HF burn areas.Few cases of HF inhalation injury have been reported to date.CASE SUMMARY A 24-year-old man suffered from extensive hydrofluoric acid burns covering 60%of the total body surface area(TBSA),including deep second degree burns on 47%and third degree burns on 13%of the TBSA,after he fell into a pickling pool containing 15%HF.Comprehensive treatments were carried out after the patient was admitted.Ventricular fibrillation occurred 9 times within the first 2 h,and the lowest serum Ca2+concentration was 0.192 mmol/L.A dose of calcium gluconate(37 g)was intravenously supplied during the first 24 h,and the total amount of calcium gluconate supplementation was 343 g.Extracorporeal membrane oxygenation(ECMO)was applied for 8 d to handle the acute respiratory distress syndrome(ARDS)induced by the HF inhalation injury.The patient was discharged after 99 d of comprehensive treatment,including skin grafting.CONCLUSION Extensive HF burns combined with an inhalation injury led to a potentially fatal electrolyte imbalance and ARDS.Adequate and timely calcium supplementation and ECMO application were the keys to successful treatment of the patient.

Effect of glial cells on remyelination after spinal cord injury

Remyelination plays a key role in functional recovery of axons after spinal cord injury.Glial cells are the most abundant cells in the central nervous system.When spinal cord injury occurs,many glial cells at the lesion site are immediately activated,and different cells differentially affect inflammatory reactions after injury.In this review,we aim to discuss the core role of oligodendrocyte precursor cells and crosstalk with the rest of glia and their subcategories in the remyelination process.Activated astrocytes influence proliferation,differentiation,and maturation of oligodendrocyte precursor cells,while activated microglia alter remyelination by regulating the inflammatory reaction after spinal cord injury.Understanding the interaction between oligodendrocyte precursor cells and the rest of glia is necessary when designing a therapeutic plan of remyelination after spinal cord injury.

Diagnosis and Treatment of Cholangiocarcinoma: A Consensus from Surgical Specialists of China

Cholangiocarcinoma refers to malignant tumors that develop in epithelial lining of biliary system, and it is divided into two categories according to tumor location, intrahepatic cholangiocarcinoma （ICC） and extrahepatic cholangiocarcinoma （ECC）. ICC occurs from the epithelial cells of the intrahepatic bile duct, its branches and interlobular biliary tree; and ECC is divided into hilar cholangiocarcinoma and distal cholangiocarcinoma by the circumscription at the confluence of cystic duct and the common hepatic duct.

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.

Complex dynamic behaviors in hyperbolic-type memristor-based cellular neural network

This paper presents a new hyperbolic-type memristor model,whose frequency-dependent pinched hysteresis loops and equivalent circuit are tested by numerical simulations and analog integrated operational amplifier circuits.Based on the hyperbolic-type memristor model,we design a cellular neural network(CNN)with 3-neurons,whose characteristics are analyzed by bifurcations,basins of attraction,complexity analysis,and circuit simulations.We find that the memristive CNN can exhibit some complex dynamic behaviors,including multi-equilibrium points,state-dependent bifurcations,various coexisting chaotic and periodic attractors,and offset of the positions of attractors.By calculating the complexity of the memristor-based CNN system through the spectral entropy(SE)analysis,it can be seen that the complexity curve is consistent with the Lyapunov exponent spectrum,i.e.,when the system is in the chaotic state,its SE complexity is higher,while when the system is in the periodic state,its SE complexity is lower.Finally,the realizability and chaotic characteristics of the memristive CNN system are verified by an analog circuit simulation experiment.

Nonlinear dynamics in non-volatile locally-active memristor for periodic and chaotic oscillations

Complexity and abundant dynamics may arise in locally-active systems only, in which locally-active elements are essential to amplify infinitesimal fluctuation signals and maintain oscillating. It has been recently found that some memristors may act as locally-active elements under suitable biasing. A number of important engineering applications would benefit from locally-active memristors. The aim of this paper is to show that locally-active memristor-based circuits can generate periodic and chaotic oscillations. To this end, we propose a non-volatile locally-active memristor, which has two asymptotically stable equilibrium points(or two non-volatile memristances) and globally-passive but locally-active characteristic. At an operating point in the locally-active region, a small-signal equivalent circuit is derived for describing the characteristics of the memristor near the operating point. By using the small-signal equivalent circuit, we show that the memristor possesses an edge of chaos in a voltage range, and that the memristor, when connected in series with an inductor,can oscillate about a locally-active operating point in the edge of chaos. And the oscillating frequency and the external inductance are determined by the small-signal admittance Y(iω). Furthermore, if the parasitic capacitor in parallel with the memristor is considered in the periodic oscillating circuit, the circuit generates chaotic oscillations.

液力变矩器空化数值模拟及对性能的影响

基于计算流体动力学,从是否考虑空化两个角度分别数值模拟液力变矩器流场并绘制外特性曲线,通过试验验证仿真结果准确性。为了深入剖析空化对于液力变矩器内/外特性的影响规律,基于Q准则涡识别方法提取三维涡结构特征,分析低速比工况下各叶片表面空化特征动态演化规律,重点研究导轮叶片处空化现象,阐明空化对流场时空结构分布及能量损耗的影响机理。结果表明:①考虑空化的数值模拟与试验结果吻合度高,外特性预测误差在3%以内;②不考虑空化的数值模拟结果中泵轮转矩系数与试验数据误差较大,启动工况下误差在20%以上,仿真结果严重失真;③泵轮转速为2000 r/min时,速比为0.4的工况是空化消失的临界点,随着速比降低,空化现象及其影响越发明显。研究结果可为液力变矩器高精度数值模拟提供理论指导。