Research progress on molecular mechanism of transcription factor C/EBPβ in lung diseases / 中华危重病急救医学

CCAAT enhancer binding protein β (C/EBPβ), as a nuclear transcription factor necessary for the development of liver, airway epithelium, and adipose tissue, plays a vital role in physiological processes related to cell proliferation, apoptosis, and differentiation. However, the up-regulation of C/EBPβ activates signal pathways related to inflammatory response, epithelial-mesenchymal transition, cell proliferation and invasion, immune response, and angiogenesis by regulating a series of downstream genes transcription promotes the development of lung diseases. Therefore, targeting C/EBPβ may be a potential treatment strategy for lung diseases. This paper summarizes the regulatory effects of C/EBPβ and related signaling pathways in lung infection, asthma, chronic obstructive pulmonary disease, lung injury, pulmonary fibrosis, and lung cancer to provide a theoretical basis for the precision medicine of lung diseases.

Serpins as important protective factors in the pathogenesis of acute lung injury/acute respiratory distress syndrome / 中华危重病急救医学

Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is a common respiratory disease in clinic, and with a pathological manifestation of pulmonary edema, decreased pulmonary compliance as well as pulmonary epithelial/endothelial cells injury. At present, it was suggested that systemic inflammatory response syndrome (SIRS) caused by various causes which play an important role in the occurrence and development of ALI/ARDS. Widely activated neutrophils can migrate to lung tissue and release plenty of proteases in the procedure of SIRS, including neutrophil serine proteases (NSPs), lysozyme, myeloperoxidase and collagenase, which can induce severe lung injury. Meanwhile, NSPs, such as neutrophil elastase (NE), cathepsin G (CG), proteinase 3 (PR3) and neutrophil serine proteinase 4 (NSP4), are important in the pathogenesis of ALI/ARDS. Therefore, Serpins may protect lung tissue by inhibiting NSPs. However, the specific mechanism of Serpins is not totally clear. In this article, we will discuss the mechanism of action of NSPs in the inflammatory response of ALI/ARDS, the structural overview of Serpins, the primary role of Serpins in ALI/ARDS,such as the inhibition of NSPs activity, other roles of Serpins in ALI/ARDS, such as the inhibition of inflammatory factor release, regulation of apoptosis and protection of vascular endothelial cells and pulmonary surfactant-associated glycoprotein D (SP-D), and the clinical application of exogenous Serpins in ALI/ARDS to explore the role of Serpins in the pathogenesis of ALI/ARDS. The aim is to provide new ideas and strategies for the clinical treatment of ALI/ARDS.

Research progress on application of metabolomics in acute lung injury / 中华危重病急救医学

Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is a life-threatening lung disease characterized by refractory hypoxemia. Metabolomics is an emerging discipline for qualitative and quantitative analysis of small molecular weight metabolites in organisms or cells. Mass attention has been paid to its role in disease diagnosis and treatment. Recently, many metabolites based on metabolomics have been proposed as potential biomarkers for early development and prognosis of ALI/ARDS, and provide insights into new targeted interventions. Based on metabolomics, this article discusses the role of endogenous metabolites in the pathogenesis and biomarkers of ALI/ARDS, and summarizes its application in medical therapy.

Value of serum YKL-40 in the diagnosis of anti-MDA5-positive patients with dermatomyositis complicated with severe pulmonary injury / 北京大学学报(医学版)

OBJECTIVE@#To investigate the value of serum and bronchoalveolar lavage fluid (BALF) chitinase-3-like-1 protein (YKL-40) in the diagnosis of anti-melanoma differentiation-associated gene 5 (MDA5)-positive dermatomyositis (DM) patients complicated with serious pulmonary injury, including rapidly progressive interstitial lung disease (RP-ILD) and pulmonary infection.@*METHODS@#Anti-MDA5 antibodies positive patients with DM who were hospitalized in the Department of Rheumatology of China-Japan Friendship Hospital from 2013 to 2018 were involved in this study. Demographic information, clinical, laboratory and imaging data were retrospectively collected. ELISA was used to detect the serum and BALF levels of YKL-40. The receiver operating characteristic (ROC) curve was drawn, and the area under ROC curve (AUC) was used to evaluate the diagnostic value of serum YKL-40 for pulmonary injury.Interstitial lung disease (ILD) was confirmed by chest high-resolution CT (HRCT). RP-ILD was defined as progressive respiratory symptoms such as dyspnea and hypoxemia within 3 months, and/or deterioration of interstitial changes or appearace of new pulmonary interstitial lesions on chest HRCT. Pulmonary infection was considered as positive pathogens detected in qualified sputum, blood, bronchoalveolar lavage fluid or lung biopsy specimens.@*RESULTS@#A total of 168 anti-MDA5-positive DM patients including 108 females and 60 males were enrolled in the study. Of these patients, 154 had ILD, and 66(39.3%) of them presented RP-ILD. Seventy patients with pulmonary infection were confirmed by etiology. In the patients with RP-ILD, 39 (59.1%) of them were complicated with pulmonary infection. While only 31 cases(30.4%) had pulmonary infection in the non-RP-ILD patients. The incidence of pulmonary infection in the patients with RP-ILD was significantly higher than that of those with non-RP-ILD (P < 0.001). The serum YKL-40 levels in the RP-ILD patients with pulmonary infection were the highest compared with RP-ILD without pulmonary infection, non-RP-ILD with pulmonary infection and non-RP-ILD without pulmonary infection groups among all the patients [83 (42-142) vs. 42 (21-91) vs. 43 (24-79) vs. 38 (22-69), P < 0.01].The sensitivity, specificity and AUC of serum YKL-40 in the diagnosis of RP-ILD complicated with pulmonary infection were 75%, 67%, and 0.72, respectively. The AUC of diagnosed of anti-MDA5 positive DM patients complicated with RP-ILD and pulmonary infection was higher than that of patients complicated with only RP-ILD and only pulmonary infection (0.72 vs. 0.54 and 0.55, Z=2.10 and 2.11, P < 0.05).@*CONCLUSION@#The prognosis of anti-MDA5-positive DM patients with RP-ILD and pulmonary infection were poor. Serum YKL-40 level can be used as a helpful tool for the diagnosis of coexistence of these conditions in the patients.

Safety and effectiveness of hemoperfusion on the removal of uremic toxins in chronic kidney disease / 药学学报

The goal of the present study was to determine the effectiveness and safety of hemoperfusion (HP) in beagle dogs with chronic kidney disease (CKD). The experimental protocol was approved by the Institutional Animal Care and Use Committee of Tianjin Institute of Pharmaceutical Research New Drug Evaluation Research (IACUC2019071501). Twelve CKD model beagles were randomly divided into two groups: a low-frequency treatment group (n = 6) and a high-frequency treatment group (n = 6). The dogs in the high- and low-frequency groups received HP treatment every 3 days and once per week, respectively, for two treatments, with each session lasting 2 h. The test results showed that high-frequency HP treatment significantly decreased the accumulation of toxins in the CKD beagles. Hematology, coagulation function, electrolytes and liver function indicated that the HP treatment was safe. The body index effects were consistent between the low- and high-frequency treatment groups. Therefore, HP treatment once every 3 days was safe at the animal level. Multiple HP treatments every 3 days were more conducive than weekly treatments to the removal of uremic toxins with better prognosis and had no associated safety hazards.

Electroacupuncture at "Zusanli" (ST36) and "Chize" (LU5) of mother rats exposed to nicotine during pregnancy and lactation has a protective effect on development of lung function and morphology in neonatal rats / 针刺研究

OBJECTIVE: To compare the different effect of electroacupuncture (EA) at "Zusanli" (ST36) and "Chize" (LU5) of mother rats exposed to Nicotine during pregnancy and lactation on lung function and morphological changes in offspring rats, so as to explore the most effective acupoint for improving the development of lung in neonatal rats. METHODS: A total of 24 female pregnancy SD rats were randomly divided into 4 groups: normal control, model, EA-ST36 and EA-LU5 (n＝6 rats in each group). Rats of the normal group were treated by subcutaneous injection of normal saline, and those of the other 3 groups treated by subcutaneous injection of nicotine (1 mg•kg－1•d－1) beginning from the 6th day to about the 21st day of pregnancy (childbirth day) for nicotine exposure during pregnancy and lactation. The daily EA treatment (2 Hz /15 Hz，1 mA) was applied to bilateral ST36 and LU5 for 20 min, beginning from the 6th day of pregnancy to the 21st day (childbirth day). The lung function of the offspring rats including the peak inspiratory flow (PIF), peak expiratory flow (PEF), lung resistance (RL), exhalation resistance (RE)and lung dynamic compliance (Cdyn) was detected by using a lung function analysis system. Histopathological changes (severity of alveolarization) of the offspring rats' lung tissue were observed under microscope after H．E. stain. RESULTS: Compared with the normal group, the PIF, RL and RE values were significantly increased (P0.05)．. CONCLUSION: EA of ST36 and LU5 of mother rats experiencing nicotine exposure during pregnancy and lactation can improve the lung function and morphological changes in neonatal rats, and the effect of ST36 is relatively better.

Effect of electroacupuncture at "Zusanli" (ST 36) and "Yanglingquan" (GB 34) on perinatal nicotine-exposure-induced lung function and morphology of neonatal rats / 中国针灸

OBJECTIVE@#To compare the effects of electroacupuncture (EA) at "Zusanli" (ST 36) versus "Yanglingquan" (GB 34) in the pregnant rats on perinatal nicotineexposureinduced lung function and morphology of newborn rats and explore the rule of acupoint effect in EA for the prevention from lung dysplasia in newborn rats.@*METHODS@#A total of 24 female SD rats were randomized into a normal saline group (S group), a nicotine group (N group), a nicotineST 36 group (N + ST 36 group) and a nicotineGB 34 group (N+GB 34 group), 6 rats in each one. Starting at the 6th day of pregnancy, 0.9% sodium chloride solution was injected subcutaneously in the S group, 1 mg/kg; and in the rest 3 groups, nicotine of the same dose was injected through to the 21st postnatal day to establish the perinatal nicotineexposure model. Simultaneously, during model preparation, EA was applied at "Zusanli" (ST 36) and "Yanglingquan" (GB 34) in the N+ST 36 group and the N+GB 34 group respectively, once a day, through to the 21st postnatal day. The lung function analytic system for small animal was adopted to observe the changes in lung function indicators in newborn rats, such as peak inspiratory flow (PIF), peak expiratory flow (PEF), expiratory resistance (RE), inspiratory resistance (RI) and dynamic compliance (Cdyn). HE staining was used to observe the morphological changes of lung, such as alveolar fusion and rupture.@*RESULTS@#Compared with the S group, PEF and Cdyn were lower and PIF, RI and RE higher in the N group (all 0.05).@*CONCLUSION@#Electroacupuncture at "Zusanli" (ST 36) in the pregnant rats significantly improves the perinatal nicotineexposureinduced lung function and morphology of newborn rats than electroacupuncture at "Yanglingquan" (GB 34).

The establishment and application of safety evaluation and key technology research system for modem Chinese herbal drug / 中国比较医学杂志

The adverse reactions caused by traditional Chinese medicine have occurred frequently, but there is a lack of scientific,objective and standardized methods for safety evaluation of traditional Chinese medicine.In the process of preclinical evaluation of traditional Chinese medicine, it is imperative to form a set of scientific, standardized and feasible evaluation system of modem Chinese herbal drug.We established the preclinical safety evaluation system of modem Chinese herbal drug including the quality control system of samples for the preclinical safety evaluation, the toxicity evaluation system of modem Chinese herbal drug and its preparation and the evaluation management system, and standardized each research link of preclinical evaluation of traditional Chinese medicine.Whether from protecting patients' health and increasing the safety of clinical medication, or from enriching and improving traditional Chinese medicine science, developing traditional Chinese medicine and promoting mutual connection of traditional Chinese medicine and international medicine, it has important instructional significance and application value.

Magnetic resonance imaging study of degenerative spondylolisthesis cartilage endplate changes / 安徽医科大学学报

Objective To study the relationship between degenerative lumbar spondylolisthesis and degeneration of cartilage endplate by magnetic resonance imaging.Methods The median sagittal scanning of LA/L5 and L5/S1 intervertebral discs of all subjects were performed by magnetic resonance imaging with T2.Measureed the inclination angle of the front half of the endplate and the inclination angle of the posterior half of the endplate,then the ratio of the anterior horn and the posterior horn was calculated as the change rate of the endplate.The differences of the rate of cartilage endplate in the corresponding stage of spondylolisthesis group and normal group were compared.Results In L4 lumbar spondylolisthesis group,both upper and lower endplate of L4/L5 intervertebral disc have significant differences between the lumbar spondylolisthesis group and the normal group (t =11.280,-3.765,P =0.000).In L5 lumbar spondylolisthesis group,there are significant differences between the lumbar spondylolisthesis group and the normal group (t =11.280,-3.765,P =0.000),both upper and lower endplate of L5/S1 intervertebral disc;and significant differences were found among the upper and lower endplates of the L5/S1 (t =4.633,P =0.000).Among all the subjects,between the upper and lower endplate of L4/L5,significant differences were found,too(t =17.377,3.137,2.199,P =0.000,0.005,0.035).In addition to the above,the differences were not statistically significant.Therefore,lumbar spondylolisthesis can lead to degenerative in cartilage endplate of Slippage stage.Conclusion The degree of degeneration of the anterior and the posterior half of the same cartilage endplate is asymmetrical,for example,the degeneration of the posterior half of the upper endplate is worse than that of the anterior half of the plate,but the degeneration of the anterior half of the lower endplate is worse than that of the posterior half endplate.The degenerative degree of cartilage endplate was less affected by lumbar spondylolisthesis in the non slip stage.

Application of gastroepiploic tunnel esophagogastrostomy in minimally invasive esophagectomy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the clinical efficacy and safety of gastroepiploic tunnel esophagogastrostomy applied in minimally invasive esophagectomy and gastroesophageal cervical anastomosis.</p><p><b>METHODS</b>Clinical data of 137 esophageal cancer patients who received minimally invasive esophagectomy from December 2013 to June 2015 in Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University were analyzed retrospectively, including 84 patients receiving anastomosis with tubular anastomat (circular staple group), and 53 patients receiving gastroepiploic tunnel anastomosis(tunnel group, position of tunnel anastomosis located in the side of gastrocolic omentum, about 2-3 cm apart from fundus). Incidence of postoperative anastomotic leakage and stricture was compared between two groups.</p><p><b>RESULTS</b>All the 137 patients completed minimally invasive esophageal surgeries successfully without conversion to open thoracic or abdominal operation. The time for anastomosis was(20.2±3.1) minutes in circular stapler group and (38.9±2.9) minutes in tunnel group respectively, and the difference was statistically significant (t=75.22, P=0.000 0). The incidence of postoperative anastomotic leakage was 21.4%(18/84) in circular stapler group and 0(0/53) in tunnel group respectively, and the difference was statistically significant (P=0.000 3). All the patients were followed up for more than 6 months. During follow-up period, the incidence of postoperative anastomotic stricture was 14.3%(12/84) in circular stapler group and 3.8%(2/53) in tunnel group respectively, and the difference was statistically significant(P=0.047 9).</p><p><b>CONCLUSION</b>The gastroepiploic cervical tunnel anastomosis is safe and effective and can reduce the incidence of postoperative anastomotic leakage as well as anastomotic stricture.</p>

Radical cystectomy in patients with pathological non-muscle invasive bladder cancer / 北京大学学报(医学版)

Objective:Carcinoma of bladder is the most common malignancy in the urinary system in China.Most patients with this disease had non-muscle invasive bladder cancer (NMIBC)at the time of diagnosis.Radical cystectomy was indicated for patients with high risk or refractory NMIBC.We aimed to investigate the overall survival and disease-specific survival and related influence factors in patients un-dergoing radical cystectomy for pathological non-muscle invasive bladder cancer.Methods:From Jan. 2006 to Dec.2012,a total of 164 patients with pathological non-muscle invasive bladder cancer under-went radical cystectomy in Peking University First Hospital.Clinical data were retrospectively collected. Incidence of lymph node metastasis and disease recurrence were calculated.The risk factors of disease re-currence were analyzed.Kaplan-Meier plots were used to estimate the overall survival and cancer-specific survival.Multivariate Cox regression analysis was used to evaluate the prognostic factors for survival.Re-sults:Of all the patients included,159 had T1 disease,and 5 had CIS only.The median follow-up dura-tion was 46.5 months (range:7 -99 months).Fourteen patients were lost during the follow-up.Lymph node metastasis was noted in 6 patients (3.7%),4 patients had N1 disease,one patient had N2 di-sease,and one patient had N3 disease.Disease recurrence occurred in 16 patients (9.8%).The most common recurrence sites were the liver,bones,and lungs.The 5-year overall survival and disease-spe-cific survival for all the patients were 85% and 91%,respectively.The patients who underwent pelvic lymph node dissection showed a better prognosis in terms of disease-specific survival than those without (P =0.012).Patients with recurrence harbored a significant poorer survival (P <0.001).According to univariate Cox regression analysis,whether lymph node dissection was performed was an independent risk factor of disease recurrence (P =0.050,OR =2.695,95%CI 0.999 -7.271).In COX regression mo-del,age (P =0.008,OR =1.071,95%CI 1.018 -1.126)and whether lymph node dissection was performed (P =0.011,OR =3.385,95%CI 1.329 -8.621)were related to disease-specific survival. Conclusion:Patients with pathological non-muscle invasive bladder cancer underwent early radical cys-tectomy have a favorable prognosis,and bilateral pelvic lymph node dissection is essential for this proce-dure as it gains a survival benefit for the patients.

A metrical analysis of biomedical patents in Hunan Province / 中华医学图书情报杂志

Objective To provide the service for scientific innovation and competition in biomedical industry of Hunan Province and the reference for working out biomedical patent strategies.Methods The data of biomedical patents in Hunan Province were collected using the patentEX and processed by metrics.Results The application number of patents increased from year to year with a high expiry rate.The technology of biomedical patents has entered into its mature period and the application of patents was focused on several important IPC classifications.Conclusion Tra-ditional technologies play a main role in biomedical industry of Hunan Province, but Hunan Province is relatively backward in modern biological technologies.The application number of invented biomedical patents is rather large, but their overall academic level is rather low.The majority of biomedical industry enterprises lack of competition awareness.It is thus necessary to strengthen the development of modern biological technologies, improve the aca-demic level of biomedical patents, increase the competition awareness of biomedical industry enterprises, lay stress on cooperative development of biomedical patents and on support of biomedical industry enterprises.

Anatomy, histochemistry and phytochemistry of eight medicinal plants of Fritillaria from Xinjiang, China / 中国药学杂志

OBJECTIVE: To investigate the structural features of vegetative organs, the location of alkaloids and saponins, and the contents of sipeimine-3β-D-glucoside, sipeimine and peiminine to clarify the similarities and differences in the bulbs of medicinal plants of Fritillaria from Xinjiang. METHODS: Anatomy, histochemistry and phytochemistry approaches were used. RESULTS: All the bulbs consisted of epidermis, parenchyma cells and closed collateral vascular bundles. The basic structure of bulbs was similar to medicinal plants of Fritillaria, but no feature could characterize the species. The histochemical test revealed that alkaloids and saponins were present in the bulbs, but the intensity and parts of histochemical reaction differed among different medicinal plants. The alkaloids existed in the parenchyma cells and vascular bundle of bulbs, while the saponins were present in the epidermis and parenchyma cells surrounded vascular bundle of bulbs. The phytochemical analysis revealed that sipeimine-3β-D-glucoside, sipeimine and peiminine were commonly present in the bulbs of F. verticillata, F. tortifolia, F. verticillata var. albidoflora and F. yuminensis, and the content of peiminine was higher than those of sipeimine-3β-D-glucoside and sipeimine except F. yuminensis. Peiminine was absent in the bulbs of F. walujewii and F. pallidiflora. CONCLUSION: When choosing the species of Fritillaria, the fact that parenchyma cells have a large percentage and the total number of vessel is high in the bulbs of the medicinal plants should be fully considered. Data obtained in this research can be used to help identify and standardize the plant material and improve the output and quality of medicinal plants of Fritillaria from Xinjiang.

Prognostic value of lymphovascular invasion in patients with bladder cancer treated by radical cystectomy / 中华泌尿外科杂志

Objective To explore whether lymphovascular invasion can be used as a prognostic indicator in patients with bladder cancer underwent radical cystectomy.Methods The series included clinical data of 459 patients who had underwent radical cystectomy for bladder cancer between January 2006 and December 2012 in our hospital.Among all the patients,391 were male while 68 were female.Pathological grade G1 was diagnosed in 47,G2 in 104 and G3 in 308.Amount of pathological stage T1 or Tis or Ta or T0 was 167,T2 127,T3 89 and T4 76.Of all the patients,92 had lymph node metastasis.Follow-up time was between 13 and 99 months.The presence or absence of lymphovascular invasion was determined by HE staining in the radical cystectomy specimen.The x2 test was used to detect the association between lymphovascular invasion and several clinicopathological features,the Kaplan-Meier method was used to compare recurrence-free survival according to findings of lymphovascular invasion in the surgical specimen,and the multivariate Cox proportional-hazards regression model was used to assess the prognostic significance of some factors.Results Lymphovascular invasion was detected in 128 (28％) specimens.Among them,44 (34％) had tumor recurrence.Lymphovascular invasion was significantly associated with gender,tumor grade,pathological stage,lymph node metastasis and disease recurrence.Recurrence-free survival in patients without lymphovascular invasion was significantly higher than that in those with lymphovascular invasion (P＜ 0.05).Cox proportional hazards model showed that age,pathological stage and lymph node metastasis were independent predictors for disease recurrence.Conclusion In patients with bladder cancer underwent radical cystectomy,lymphovascular invasion may have a significant association with some prognostic parameters,but it can not be used as an independent predictor of disease recurrence.

Analysis of the genetic stability of the master virus seeds for live attenuated influenza vaccine produc-tion / 中华微生物学和免疫学杂志

Objective To analyze the genetic stability of master virus seed lots of live attenuated influenza vaccineA/17/California/2009/38(H1N1)andA/17/Perth/09/87(H3N2)strains.Methods The master virus seed lots were inoculated into chicken eggs for subculture.The complete genome of the 2nd, 3rd, 5th and 10th generations of viruses were amplified and sequenced.The genes encoding hemagglu-tinin ( HA) and neuraminidase ( NA) were compared with those of the WHO recommended circulating wild-type virus strains used for vaccine production in northern hemisphere during 2011-2012 influenza season.Six internal genes (PB2, PB1, PA, NP, M and NS) of each virus generation were compared with their master donor virus strain (A/Leningrad/134/17/57) for the evaluation of the genetic stability.Results The muta-tion rates of H1N1 and H3N2 strains after 10 passages were 0.035%and 0.022%, respectively.No muta-tions were found at the critical sites for controling thecold adapted ( ca) , temperature sensitive ( ts) and at-tenuated ( att) phenotypes.Conclusion The live attenuated influenza vaccine strains possessed high genet-ic stability as their tenth generations still shared 99% of homology with the original seed lots.All of the working virus seed lots met the requirements of Pharmacopoeia of the People′s Republic of China ( 2010 edition) .

Microfluidic cell chip method to analyze CD14+monocyte myeloperoxidase expression in acute myelomonocytic leukemia patients / 中国肿瘤临床

Objective:A method that is based on microfluidic cell chip technology was developed for the first time to analyze CD14+monocyte myeloperoxidase (MPO) expression in myelomonocytic leukemia (M4) patients. CD14+monocyte MPO expression in M4 patients was preliminarily discussed. Methods:a. The chip was prepared by using polydimethylsiloxane as the host material and by secondary foam molding. b. A total of 48 clinically diagnosed M4 patients and 52 patients with normal myelogram were included as the test and control groups, respectively. c. A method based on the microfluidic cell chip approach was established to detect CD14+mono-cytes and to determine the positive rate and degree of MPO expression in the cells. d. The microfluidic cell chip technique was used to compare CD14+monocyte MPO expression in M4 patients with that in the control. Results:a. The designed microfluidic single cell analysis chip allowed the entry of granulocytes into the corresponding microfluidic channels. Thus, blood cells were separated. Numer-ous ghost corpuscles surrounded the separated white blood cells (WBCs). WBC morphology did not show obvious changes. b. The posi-tive rate of MPO expression and the activity of CD14+monocytes in the bone marrow of M4 patients were significantly higher than those in the bone marrow of the control (P<0.05). Conclusion:A method based on microfluidic single cell technology was developed for the first time to analyze the MPO expression in CD14+monocytes. CD14+monocyte MPO activity in M4 patients was significantly higher than in the control. CD14+monocyte MPO activity can be used as an auxiliary examination marker for clinical diagnosis.

Heterogenous acellular dermal matrix seeded with adipose derived stem cells for urethral reconstruction in a rabbit model / 中华泌尿外科杂志

Objective To assess the feasibility of heterogeneous acellular dermal matrix(ADM)seeded with adipose derived stem cells(ADSC)for urethroplasty in a rabbit model.Methods ADSC were isolated from a rabbit and expanded in vitro,then identified by flow cytometry.We seeded ADSC onto the ADM and made it into tissue-engineered urethra.12 male rabbits were removed 1 cm urethra and divided into experiment group and control group.There were 6 rabbits in each group.Reconstructed urethra with tissueengineered urethra was used in experiment group,while unseeded ADM were used in control group.Urethrography was performed at 6 months after surgery.The animals were scarified at 3 and 6 months after surgery and the repaired urethra were harvested.H&E staining and immunohistochemical staining were performed with cytokeratin AE1/AE3 and smooth muscle desmin makers.Results The morphology of isolated ADSC was with long spindle cross-links,and had multicentral growth.Flow cytometry showed that the ADSC expressed CD166,CD105,CD90 and CD44,but not expressed CD45 and CD13.The cells could growth well on the ADM and showed good biocompatibility with it.All animals could void normally,urethrography showed there was no significant stenosis.3 months after surgery,the experiment group appeared regenerated smooth muscle but not in the control group,both groups did not regenerate urothelium.At 6 months urothelium and smooth muscle cells could be observed in the experiment group,but only the smooth muscle was evident in the control group.Conclusions By applying tissue engineering methods,we can seed the ADSC onto the heterogeneous ADM and make it into tissue-engineered urethra,which can help improve the reconstructive effect of urethra.

Extra-anatomic bypass for complex aortic coarctation in adults / 中华外科杂志

<p><b>OBJECTIVE</b>To demonstrate an effective operation of extra-anatomic bypass for complex aortic coarctation in adults.</p><p><b>METHODS</b>Between July 1997 and October 2010, 51 patients underwent extra-anatomic aortic bypass. There were 39 male and 12 female patients. Mean age was (40 ± 14) years (ranging from 18 to 63 years). Operative technique of extra-anatomic bypass consisted of performing an ascending-to-descending or abdominal or femoral aorta bypass (8, 39 and 4 patients). Concomitant procedures were performed in 38 patients: 10 isolated aortic valve replacements (AVR), 11 aortic root replacements (Bentall), 4 ascending aorta replacements including 3 concomitant AVR, 5 mitral valve replacements including 3 concomitant AVR, 4 ventricular septal defect correcting with AVR, and 4 coronary artery bypass graft.</p><p><b>RESULTS</b>Mean follow-up time was (30 ± 9) months (ranging from 5 to 60 months). Two patients were reoperated for hemorrhage in descending aorta anastomosis, one of whom was dead of multiple organ failure in perioperative period. Upper-extremity blood pressure after coarctation correction with extra-anatomic aortic bypass was significantly improved (< 10 mmHg, 1 mmHg = 0.133 kPa). Arterial hypertension was well improved, except 10 patients controlled with less drug therapy. All grafts were patent without obstruction or pseudoaneurysm formation in the follow-up period evaluated by vascular ultrasound and computed tomographic angiogram.</p><p><b>CONCLUSION</b>Extra-anatomic aortic bypass is a safe and effective option for complex aortic coarctation in adults.</p>

Validation of four different risk stratification models in patients undergoing heart valve surgery in a single center in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Several risk stratification models have been developed for cardiac surgery. This study aimed to evaluate the accuracy of four existing risk stratification models, the Fuwai System for Cardiac Operative Risk Evaluation (FuwaiSCORE), the Society of Thoracic Surgeons 2008 cardiac surgery risk model for isolated valve surgery (the STS model), the European System for Cardiac Operative Risk Evaluation (EuroSCORE) and the initial Parsonnet's score (the Parsonnet model) in predicting prolonged intensive care unit (ICU) stay in Chinese patients undergoing heart valve surgery.</p><p><b>METHODS</b>Data were collected retrospectively from records of 1333 consecutive patients who received heart valve surgery in a single center between November 2006 and December 2007. Prolonged ICU stay was defined as not less than 124 hours. Calibration was assessed using the Hosmer-Lemeshow (H-L) goodness of fit test. Discrimination was assessed using the receiver-operating-characteristic (ROC) curve area.</p><p><b>RESULTS</b>The FuwaiSCORE showed good calibration and discrimination compared with other risk models. According to the H-L statistics, the value of the FuwaiSCORE was 12.82, P > 0.1. The area under ROC curve of the FuwaiSCORE was 0.81 (95%CI 0.78 - 0.84).</p><p><b>CONCLUSIONS</b>Our study suggests that the FuwaiSCORE is superior to the other three risk models in predicting prolonged length of ICU stay in Chinese patients with heart valve surgery. Having fewer variables, the system is much easier for bedside use than other systems.</p>

Comparison in rapid detections of methicillin resistant Staphylococcus aureus / 中华检验医学杂志

Objective To compare several methods for the rapid detection of methicillin resistant StaphylOCOCCUS aureus(MRSA).Methods Forty-four Staphylococcus aureus isolates from Tianjin Medical University Cancer Institute and Hospital(TMUCIH)were detected by Oxacillin Kirby-Bauer disk diffusion method,Cefoxitin Kirby-Bauer disk diffusion method,Oxacillin micro-broth dilution method,E tests and PBP2a Latex agglutinaltion assay.These above results were compared with PCR analysis.Results PCR analysis showed that 36 MRSA strains containing mecA was identified.Thirty-two MRSA strains were detected by Oxacillin Kirby-Bauer disk diffusion method,Cefoxitin Kirby-Bauer disk diffusion method and Oxacillin micro-broth dilution method.Compared with PCR analysis,the sensitivity and specificity is 88.9%and 100%respectively.Thirty-three MRSA strains were identified by E test,with the sensitivity of 88.9%and specificity of 87.5%.Twenty-nine MRSA strains were identified by PBP2a latex agglutination assay with the sensitivity of 80.5%and specificity of 100%.Conclusions The turnaround time of PBP2a Latex agglutination assay could be reduced 24 h compared with other methods for detection of MRSA.This rapid,convenient and specific method could be applied in clinical laboratories for MRSA detection.