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Norepinephrine (NE) is often administered during the perioperative period of liver transplantation to address hemodynamic instability and to improve organ perfusion and oxygen supply. However, its role and safety profile have yet to be evaluated in pediatric living donor liver transplantation (LDLT). We hypothesized that intraoperative NE infusion might affect pediatric LDLT outcomes. A retrospective study of 430 pediatric patients (median [interquartile range] age, 7 [6.10] months; 189 [43.9%] female) receiving LDLT between 2014 and 2016 at Renji Hospital was conducted. We evaluated patient survival among recipients who received intraoperative NE infusion (NE group, 85 recipients) and those that did not (non-NE group, 345 recipients). The number of children aged over 24 months and weighing more than 10 kg in NE group was more than that in non-NE group. And children in NE group had longer operative time, longer anhepatic phase time and more fluid infusion. After multivariate regression analysis and propensity score regression adjusting for confounding factors to determine the influence of intraoperative NE infusion on patient survival, the NE group had a 169% more probability of dying. Although there was no difference in mean arterial pressure changes relative to the baseline between the two groups, we did observe increased heart rates in NE group compared with those of the non-NE group at anhepatic phase (P=0.025), neohepatic phase (P=0.012) and operation end phase (P=0.017) of the operation. In conclusion, intraoperative NE infusion was associated with a poorer prognosis for pediatric LDLT recipients. Therefore, we recommend the application of NE during pediatric LDLT should be carefully re-considered.

Endothelial progenitor cell (EPC)-induced angiogenesis activity is enhanced in hepatocellular carcinoma (HCC); however, the contributing factors remain unknown. The present study aimed to investigate the factors influencing the number of EPCs and circulating progenitor cells (CPCs), as well as the expression levels of vascular endothelial growth factor receptor 2 (VEGFR-2) and CD34, in patients with HCC. The expression levels of VEGFR-2 and CD34 were assessed in 72 HCC tumor and matched adjacent tissue microarrays by immunohistochemistry. The associations between VEGFR-2 or CD34 expression in tumors, clinicopathological characteristics and overall survival rates were analyzed. The number of EPCs and CPCs were analyzed in the peripheral blood of patients with HCC. In this study, high expression levels of VEGFR-2 and CD34 were detected in the tumor tissues of 41 (56.9%) and 44 (61.1%) patients, respectively. VEGFR-2 expression was significantly associated with tumor size (P

Physical stress is one of the most important factors affecting morphine-induced conditioned place preference (CPP). Convincing evidences demonstrate that physical stress can activate lateral habenular (LHb) neurons. However, the mechanism by which physical stress regulates morphine-induced CPP through LHb remains unclear. In this study, we examined the impact of forced swimming stress (FSS) on morphine-induced CPP in rats. We found that FSS significantly decreased the CPP scores of rats compared with the normal morphine administration rats. Meanwhile, we detected the expression of DARPP-32 phosphorylation (p-DARPP-32) in the nucleus accumbens (NAc), and CaMKII in LHb. The results show that FSS enhanced the expression of CaMΚII in LHb, while it reduced the level of p-DARPP-32 expression in the NAc. Furthermore, by microinjecting AAV-CaMKII or AAV-RNAi into LHb, we demonstrated that an overexpression of CaMKII could reduce morphine-induced CPP scores of rats, while knock-down CaMΚII could restore morphine-induced CPP scores, which were interfered by FSS. In addition, by microinjecting DiI into the ventral tegmental area (VTA) and tail of VTA (tVTA) unilaterally, and an anterograde tracing virus (AAV-CaMKII-mCherry) into LHb unilaterally, we verified the neural projections from LHb to tVTA. Taken together, our findings suggest that FSS could activate LHb neurons through CaMΚII, and inhibit morphine-induced CPP through the LHb-tVTA pathway.

Conventional f−x empirical mode decomposition (EMD) is an effective random noise attenuation method for use with seismic profiles mainly containing horizontal events. However, when a seismic event is not horizontal, the use of f−x EMD is harmful to most useful signals. Based on the framework of f−x EMD, this study proposes an improved denoising approach that retrieves lost useful signals by detecting effective signal points in a noise section using local similarity and then designing a weighting operator for retrieving signals. Compared with conventional f−x EMD, f−x predictive filtering, and f−x empirical mode decomposition predictive filtering, the new approach can preserve more useful signals and obtain a relatively cleaner denoised image. Synthetic and field data examples are shown as test performances of the proposed approach, thereby verifying the effectiveness of this method.

Background: The surgical treatment of humeral fractures is controversial, and conservative therapy of pathologic fractures is not recommended. Materials and Methods: We performed a retrospective study of eight patients who had pathological humeral shaft fractures. All fractures were stabilized with ante-grade intramedullary nailing and wide resection of the tumor. Bone defects were filled with polymethylmethacrylate cement augmentation. Results: The mean operative time for the procedure was 160 min (range, 120-190 min), and the mean duration of hospitalization was 10.5 days (range, 5-15 days). Relief of pain was rated as good to excellent. There were no wound problems, deep infections, nerve palsies, or implant failures observed. X-ray studies demonstrated the improved stability of the humerus. Conclusion: Interlocking intramedullary nailing for pathological humeral shaft fractures provides immediate stability and can be accomplished with wide resection of tumor and bone defect augmentation with cement. Early return of functional status and pain relief greatly improved the patient's quality of life.

Based on information entropy theory, the dynamically evolutional characteristics of urban land structure were analyzed in the time and space from 2001-2008, in Changde city. In time, the entropy and equilibrium of urban land information increased first and then decreased, with a slight fluctuation in 2007. The overall entropy and equilibrium showed a relatively stable trend, but the degree of dominance and equilibrium were the opposite trend. In space, information entropy, degree of equilibrium and dominance showed significant differences in each designated town of Changde. Further by constructing a multiple regression model to investigate economic driving force of the urban land evolution in Changde city, this paper found that the level of urbanization was the most important economic driver, followed by investment in fixed assets and GDP.

An 83-year-old male who had received left total hip arthroplasty 20 years ago for osteoarthritis presented with the bloody stool and mucus discharge for 1 week. He had history of old cerebral vascular accident, senile dementia and became bedridden for 15 years. Besides, he underwent T-loop colostomy due to anal enema trauma 5 years ago. His family and trauma histories were unremarkable. The physical examination revealed irreducible external rotation and abduction of left thigh. There was no local tenderness or rebounding pain …