Genetic studies of primary biliary cholangitis in the post-GWAS era / 临床肝胆病杂志

With the constant increase in the awareness of primary biliary cholangitis (PBC) and the continuous improvement in related diagnostic methods in the past two decades, the incidence and prevalence rates of PBC tend to increase and PBC is now the most common autoimmune liver disease worldwide. A series of family-based studies in the early stage have shown that PBC has strong genetic tendency, and subsequent genomic analyses have been performed for PBC in different populations and have obtained a large amount of genetic data. Future genetic studies of PBC will focus on translating these results into clinical practice.

MiR-494 alleviates hepatic ischemia-reperfusion injury in rats by activating PI3K/AKT signaling pathway / 器官移植

Objective To investigate the effect and related mechanism of microRNA (miR)-494 on the hepatic ischemia-reperfusion injury (HIRI). Methods Twenty-four male SD rats were randomly divided into four groups (n=6 in each group). In the sham operation group, abdominal surgery without hepatic ischemia-reperfusion was performed. In the HIRI group, partial liver ischemia was performed for 60 min, followed by 6 h perfusion. In the HIRI+agomir-miR-494 group, intraperitoneal injection of agomir-miR-494 (20 μL) was daily given within preoperative 7 d. In HIRI+agomir-NC group, an equivalent quantity of agomir-NC was daily injected intraperitoneally within preoperative 7 d. The expression level of miR-494 messenger RNA(mRNA) in the liver tissues in each group was detected by reverse transcription polymerase chain reaction (RT-PCR). The expression levels of liver injury and oxidative stress related indexes were measured by relevant kits. The histopathological changes of the liver in each group were observed. The quantity of apoptotic cells and cytoplasmic histone-related DNA fragments in the liver tissues of rats was detected by relevant kits. The expression levels of the proteins related to the phosphatidylinositol-3-kinase(PI3K)/protein kinase(AKT) signaling pathway were measured by Western blot. Results The expression level of miR-494 mRNA in the rat liver tissues in the HIRI+agomir-miR-494 group was significantly higher than that in the HIRI+agomir-NC group (P < 0.01). The levels of the serum liver injury and oxidative stress related indexes in the HIRI+agomir-miR-494 group were significantly lower than those in the HIRI+agomir-NC group (all P < 0.01). Compared with those in the HIRI+agomir-NC group, the quantity of cellular necrosis was significantly reduced, the cell integrity was considerably increased and the quantity of TUNELpositive cells was evidently decreased in the HIRI+agomir-miR-494 group (all P < 0.05). The expression levels of poly ADP-ribose polymerase(PARP), cysteinyl aspartate specific proteinase-3(Caspase-3) and Bax in the HIRI+agomirmiR-494 group were significantly lower than those in the HIRI+agomir-NC group (all P < 0.05). The quantity of DNA fragments in the HIRI+agomir-miR-494 group was significantly less than that in the HIRI+agomir-NC group (P < 0.01). The expression levels of p-AKT, p-mammalian target of rapamycin(mTOR) and p-p70S6K in the HIRI+agomir-miR-494 group were significantly higher than those in the HIRI+agomir-NC group (all P < 0.05). Conclusions miR-494 can alleviate the severity of HIRI in rats by activating the PI3K/AKT signaling pathway.

Analysis on the external quality assessment results and comparability of detection systems and methods for tumor markers in Shandong province during 2015 and 2017 / 临床检验杂志

Objective@#To analyze the comparability of different detection systems and methods for tumor markers (TM) by reviewing the results of TM external quality assessment (EQA) in Shandong province during 2015 and 2017. @*Methods@#The results of TM EQA from the Shandong Provincial Clinical Laboratory Center during 2015 and 2017 were collected, and grouped by the detection system or method. After outliers were removed by the CLInet EQA software, the mean and coefficient of variation (CV) in each group were calculated with median as the target value. The difference of TM results in different detection systems were compared by the Kruskal-Wallis H test. @*Results@#Taking alpha-fetoprotein (AFP) as an example, the average CV of different detection methods of TM EQA during 2015 and 2017 ranged from small to large in order of microparticle enzyme immunoassay, electrochemiluminescence, acridine ester chemiluminescence and chemiluminescence. The trends of CV of the other tumor markers were similar to AFP. The average CV of individual marker in electrochemiluminescence group was lower than that in microparticle enzyme immunoassay group. The intra-group CVs of imported detection systems such as Roche, Beckman etc. were relatively ideal, and the average CVs of most tumor markers were less than 10%. However, the intra-group CVs of domestic detection systems such as Shenzhen Snibe, Zhengzhou Autobio etc. were not ideal, and the average CVs of most tumor markers were more than 10%. The target values of different detection systems varied with different items and batches, and there were great variation in carbohydrate antigen (CA) series. @*Conclusion@#The results of TM detected by the same automatic detection system are comparable. However, the results of TM detected by most different detection systems and methods are not comparable.

AngioJet in patients treated for acute deep venous thrombosis by mechanical aspiration thrombectomy combined with catheter-directed thrombolysis / 中华普通外科杂志

Objective To evaluate AngioJet in patients treated for acute deep venous thrombosis (DVT) by mechanical aspiration thrombectomy combined with catheter-directed thrombolysis (CDT).Methods A retrospective analysis of 83 acute DVT patients treated by mechanical aspiration thrombectomy combined with CDT from Dec 2014 to Oct 2018 in the Third Hospital of Hebei Medical University was conducted.Results 43 cases (routine group) were treated by mechanical aspiration thrombectomy using a large-caliber catheter combined with CDT,and 40 cases (AngioJet group) were treated by AngioJet aspiration thrombectomy combined with CDT(P ＞ 0.05).Thrombosis was completely dissolved in 28 cases in AngioJet group while in 10 cases in large-caliber catheter group.Venous damage rate was higher (38 cases vs.13 cases) in routine group.Conclusion AngioJet combined with CDT can effectively and safety remove thrombus in the lower extremity deep venous system.

A real-time qPCR method to identify diatom UPA gene for the drowning diagnosis / 中国法医学杂志

Objective To establish a Real-time quantitative PCR method (qPCR) for the detection of diatom UPA barcoding genes and evaluate its application in the drowning diagnosis. Methods The homologous sequences of diatoms UPA gene was obtained by Blast from GeneBank, based on which the universal primers for diatoms were designed. DNA were extracted from 2 common human symbiotic bacteria (Escherichia coli, Bifidobacterium longum), 3 species of planktonic bacteria, 15 species of planktonic algae, tissue samples (lung, liver and kidney) from human cadavers (28 drowning victims, 1 victims by non-drowning in the water, 3 victims deaths on land) in 32 cases. The specificity, sensitivity and repeatability of the designed primers were tested. The positive rates of diatoms detection in the drowning cases were calculated. The results of the real-time quantitative method were evaluated comparatively by Microwave Digestion-Vacuum Filtration-Automated Scanning Electron Microscopy (MD-VF-Auto SEM) and PCR-Capillary Electrophoresis (PCR-CE). Results The results showed that the primers UPA99 had strong specificity for the diatomaceae (Synedra radians, Navicula sp., Melosira varians, Cyclotella sp. and Nitzschia sp.) DNA. The melting curve of the amplified product was smooth; the peak was narrow; the melting temperature was (87±1)℃. The sensitivity of qPCR method was 1.56×10-5ng/μL with the detection range of 1.56×102ng/mL~1.56×10-5ng/μL, in contrast with the PCR-CE method (1.56×10-3ng/μL). This real-time PCR method showed high repeatability and stability with the coefficient of variation less than 2%. The detection rate of lung, liver and kidney was 89.3%, 71.4% and 64.3% respectively. Conclusion The established qPCR method, based on the universal primers designed for diatom UPA gene, has high specificity, high sensitivity and good repeatability. With a promising prospect for application, qPCR is suitable for drowning diagnosis.

Value of intraoperative Surgical Apgar Score in predicting postoperative delirium in patients undergoing pancreaticoduodenectomy / 中华麻醉学杂志

Clinical data of patients underwent pancreaticoduodenectomy due to malignant ampullary tumors from January 2013 and December 2016 in our hospital with full access to medical records were collected,and 144 patients were enrolled in total.Surgical Apgar Score (SAS) was calculated based on the intraoperative lowest mean arterial pressure,lowest heart rate and blood loss.The patients were divided into 2 groups depending on whether postoperative delirium developed or not within 7 days after surgery.The receiver operating characteristic curve of SAS in predicting postoperative delirium was drawn.The area under the curve,optimal cut-off value and sensitivity and specificity were calculated.Thirty-six patients developed postoperative delirium,and the incidence was 25.0％.The area under the curve of SAS in predicting postoperative delirium was 0.86 (95％ confidence interval 0.79-0.91).The optimal cut-off value was 6 with a sensitivity of 86％ and a specificity of 83％.In conclusion,intraoperative SAS can predict the development of postoperative delirium in patients undergoing pancreaticoduodenectomy.

Risk factor analysis on failure of internal fixation of unstable femoral intertrochanteric fractures treated with PFNA in elderly patients / 局解手术学杂志

Objective To analyze the risk factors of failure of internal fixation of unstable femoral intertrochanteric fractures treated with proximal femoral nail anti-rotation (PFNA) in elderly patients,and to provide reference for clinical treatment.Methods Collected the clinical data of 251 aged and unstable femoral intertrochanteric fracture patients who have recieved PFNA treatment from January 2012 to December 2016.Preoperative clinical general data and intraoperative clinical factors were used as analysis variable to analyze the high risk factors and risk factors of internal fixation failure in PFNA treatment by χ2 test ,Wilcoxon rank sum test and Logistic regression.Results Through the analysis of 78 aged patients with internal fixation failure after PFNA treatment,the χ2 test and Wilcoxon rank sum test showed that,type of fractures,osteoporosis Singh index grade, tip-apex distance,application of hormone,basic diseases were risk factors for internal fixation failure after PFNA treatment (P<0.05).Among thses factors,type of fractures,osteoporosis Singh index grade, tip-apex distance were independent high risk factors for internal fixation failure after PFNA treatment(P<0.05).Conclusion Severe type of fractures (type Ⅲ and Ⅳ),osteoporosis of grade 4 to 6,and tip-apex distance greater than 25 mm are high risk factors of failure of internal fixation of unstable femoral intertrochanteric fractures treated with PFNA,and it is better to give more attention and effective intervention or other treatment.

Comparison of Etomidate-Dexmedetomidine and Propofol-Dexmedetomidine sedation in patients with gastroesophageal relfux disease treated by endoluminal radiofrequency ablation / 中国内镜杂志

Objective To compare the efficacy and safety of Etomidate-Dexmedetomidine and Propofol-Dexmedetomidine sedation in patients undergoing endoscopic radiofrequency ablation of gastroesophageal relfux disease (GERD).Methods Sixty adult patients, scheduled for elective endoluminal radiofrequency ablation for GERD under sedation were prospectively randomized into Etomidate-Dexmedetomidine (Group-E,n = 30) or Propofol-Dexmedetomidine (Group-P,n = 30) group. A bolus of 0.2 μg/kg of intravenous Dexmedetomidine was followed by intermittent Etomidate or Propofol injection during the procedure in order to maintain a proper depth of sedation with a Ramsay sedation scores of 5~6. Heart rates, mean blood pressure, oxygen saturation, respiratory rates and Ramsay sedation scores were recorded before sedation (T0), at the beginning of the examination (T1), during radiofrequency energy delivery (T2), at the time of gastroscopy (T3) and at the end of therapy (T4). Inter-group differences in sedation proifles (duration, time to recovery, incidence of body movement, Ramsay sedation scores and satisfaction of patient and endoscopist) and cardio-respiratory responses (heart rate, mean arterial pressure, oxygen saturation) were determined during and after radiofrequency ablation.Results No difference was found for therapy duration, anesthesia time or the time to recovery between Group-P and Group-E. Patients receiving Propofol experienced more bradycardia (Ρ = 0.032) and had higher incidences of vasoactives used (Ρ = 0.002) compared with that receiving Etomidate. Oxygen saturation in T1 (Ρ = 0.023) and T2 (Ρ = 0.009) was lower in the Group-P. No significant difference was found for other indicators.Conclusion Etomidate-Dexmedetomidine sedation was superior to Propofol-Dexmedetomidine sedation for GERD radiofrequency therapy with more stable cardio-respiratory responses.

Effect of metformin on connexin43 expression in H9c2 cells cultured with high glucose / 中国药理学通报

Aim To investigate the effect of metformin (Met) on connexin43(Cx43) expression in H9c2 cells cultured with high glucose and the relevant mecha-nisms.Methods Rat myocardial cells H9c2 were cul-tured with high glucose , then combined with 3μmol· L-1 and 5 μmol · L-1 of Met for 24 h respectively . The viability and toxicity of H9c2 cells were detected by MTT and LDH , respectively .The expression and distribution of Cx43 were detected by immunofluores-cence staining .The intracellular oxygen species reac-tive ( ROS) level was detected by fluorescencemicrosco-py.And the expression of Cx43, P-AMPK, AMPK and GAPDH was determined by Western blot .Results The viability of H9c2 cells was increased and the level of intracellular ROS was decreased in Met group , while there existed no significant difference in LDH release among groups.Met significantly increased the phos-phorylation of AMPK and the expression of Cx 43, and improved the distribution of Cx 43 also.Conclusion The beneficial effect of Met on cardiovascular system in diabetic patients may via up-regulating the expression of Cx43 and down-regulating of intracellular ROS through activation of AMPK .

Clinical value of ultrasonographic assessment for the risk of lower limb deep vein thrombosis defluvium / 中华超声影像学杂志

Objective To evaluate the possibility of deep vein thrombosis defluvium of lower limb using ultrasonography to provide important reference for the implantation and retrieve of retrievable inferior vena cave (IVC ) filters.Methods Sixty-four patients who were diagnosed as lower limb deep vein thrombosis using ultrasonography were enrolled.Fourteen patients with critical values were allocated to high risk group,50 patients without critical value to low risk group.All the patients underwent inferior vena cava filter operation.Of all these patients,ultrosonography were performed once again before IVC filters were retrieved.Seventeen patients with broken thrombosis were allocated to unstable group,47 patients with stable thrombosis to stable group.Relationships between conditions of thrombosis and ultrasonography results were analysed.The conditions of thrombosis were recorded.The rates of thrombosis defluvium were compared.Results In high risk group,10 patients (71 .43%)had thrombosis.In low risk group,8 patients (16%)had thrombosis.There were significant differences in the rates of thrombosis defluvium beteen the high risk group and low risk group(P <0.05).In unstable group,12 patients (70.59%)had thrombosis.In stable group,6 patients (12.77%) had thrombosis,there were significant differences in the rates of thrombosis defluvium between the unstable group and stable group (P < 0.05 ).Conclusions Ultrasonography can be used to evaluate the possibility of lower extremity deep vein thrombosis defluvium which will guide the pratice of the retrievable inferior vena cava filter.

A new type occluder applied in atrial spetal defect of mini-pigs / 中国比较医学杂志

Objective To evaluate the efficacy, safety and compatibility of a new type of atrial septal defect ( ASD) occluder in atrial spetal defect mini-pigs model.Methods Five Tibet mini-pigs were selected as the ASD models which were established by the combination of atrial septal puncture and balloon dilation.Then the new type occluder was implanted for the therapy of ASD.Transthoracic echocardiography with color Doppler was used in all animals during closure and in follow up examinations.The animals were killed at 3 months after occlusion for electron microscopical observation and microscopic examination.Result The ASD models had been created in five piglets successfully without complication, all of whom were implanted successfully with the new device without shunts.Postmortem and microscopic examination of the 5 specimens 3 months after placement showed complete.Conclusion Transcatheter ASD occlusion with new type ASD occluder is safe,feasible and effective.This occlusion can repair the atrial septal defect successfully.

High-dose methylprednisolone sodium succinate therapy for acute spinal cord injury in adults：a Meta-analysis / 中国组织工程研究

BACKGROUND:Some control studies attempt to answer the advantages and disadvantages of high-dose methylprednisolone sodium succinate therapy for acute spinal cord injury in adults, but have arrived at different conclusions. OBJECTIVE:To explore the therapeutic efficacy of high-dose methylprednisolone sodium succinate therapy on acute spinal cord injury in adults by Meta analysis. METHODS:PubMed, Embase, Cochranel Library, CBMdisc, VIP and WanFang Databases were searched by computer, and relevant Chinese and English orthopedic journals were retrieved by hand. Controled trials related to high-dose methylprednisolone sodium succinate therapy of acute spinal cord injury in adults were included. The methodology quality of included trials was criticaly assessed. RevMan 5.0 software was used for data analysis. RESULTS AND CONCLUSION:Nine clinical controled trials were included. Meta-analysis results showed that compared with the conventional therapy, the neurological recovery rate after 24 hours of administration, pneumonia incidence and gastrointestinal reactions increased significantly after high-dose methylprednisolone sodium succinate therapy. However, there were no statistical differences in the rate of urinary tract infection, nonunion rate and stress ulcer incidence between these two therapies. These findings indicate that the high-dose methylprednisolone sodium succinate therapy on acute spinal cord injury in adults has better outcomes in neurological function recovery, but can lead to higher incidence of lung infection and gastrointestinal reactions. Therefore, lung infection and gastrointestinal reactions should be avoided as much as possible during the course of treatment.

Intravitreal bevacizumab with or without triamcinolone acetonide for diabetic macular edema: a meta-analysis of randomized controlled trials / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Intravitreal anti-vascular endothelial growth factor (anti-VEGF) drugs and corticosteroids are being widely used to treat diabetic macular edema (DME). The purpose of this study was to evaluate further the efficacy and safety of intravitreal bevacizumab (IVB) alone in comparison with intravitreal bevacizumab combined with triamcinolone acetonide (IVB/IVT) in the treatment of DME.</p><p><b>METHODS</b>Pertinent publications were identified through CNKI, PubMed, Medline, EMBASE, and the Cochrane Controlled Trials Register up to November 30, 2013. Two investigators independently assessed the quality of the trials, and changes in central macular thickness (CMT) and best-corrected visual acuity (BCVA) were extracted at 6 weeks and 3, 6, 12, and 24 months after the initial treatment. A meta-analysis was carried out to compare the results between the groups receiving IVB and IVB/IVT using the software RevMan 5.0.</p><p><b>RESULTS</b>A total of six randomized controlled trials (RCTs) were identified and included. The meta-analysis revealed that a significant reduction of the CMT was observed at 3 months after the initial treatment in the IVB/IVT group compared to the IVB group (P = 0.001). Also, changes in CMT at 6 weeks and 6, 12, and 24 months did not vary significantly between the IVB and IVB/IVT groups (P = 0.53, 0.76, 0.34, and 0.09, respectively). Similarly, changes in BCVA at 6 weeks and 3, 6, 12, and 24 months also did not vary significantly between the two groups (P = 0.66, 0.98, 0.81, 0.07, and 0.80, respectively). The results were robust to sensitivity analyses. However, the rate of intraocular pressure (IOP) rise after intravitreal injections varied significantly between the IVB and IVB/IVT groups (P < 0.01). A publication bias was not detected by funnel plots, the Egger method, or the Begg method.</p><p><b>CONCLUSIONS RESULTS</b>of this meta-analysis showed that the treatments with IVB alone and combined IVB/IVT were similarly effective in improving the visual acuity, and, to some degree; combined IVB/IVT appeared to offer a marginal advantage over IVB in decreasing CMT in patients with DME. However, the addition of IVT resulted in intraocular pressure rise in some treated patients.</p>

Cytoskeletal vimentin protein expression in rats with exhaustive eccentric exercise injury / 中国组织工程研究

BACKGROUND:Due to different experimental methods, the change of cytoskeleton proteins after centrifugal movement is stil controversial. OBJECTIVE:To establish exhaustive eccentric exercise injury model in rats and to observe cytoskeletal vimentin protein expression at different time. METHODS:A total of 48 male Sprague-Dawley rats were randomly and equal y divided into six groups:quiet control group, immediately after exercise group, and 12, 24, 48, 72 hours after exercise groups. In the exercise groups, the rats were subject treadmil exercise at the speed of 16 m/min in a-16° slope, for 100 minutes at the interval of 5 minutes. The quiet control group maintained unchanged, without exercise. The cytoskeletal vimentin was detected with immunohistochemical staining using anti-vimentin antibody, and vimentin expression changes were observed at different time after exhaustive eccentric exercise through the changes of target area percentage. RESULTS AND CONCLUSION:The results of target area percentage showed that, there was no significant difference between quiet control group and immediately after exercise group (P>0.05). Compared with the immediately after exercise group, the target area percentage was slightly increased in 12 hours after exercise group, without significant difference (P>0.05). Compared with the 12 hours after exercise group, the target area percentage was also slightly increased in 24 hours after exercise group, without significant difference (P>0.05). Compared with quiet control group and immediately after exercise group, the target area percentage was increased in 24 hours exercise group (P<0.05). Compared with immediately and 12 hours after exercise groups, the target area percentage was increased significantly in 48 hours after exercise group (P<0.01). Compared with 48 hours after exercise group, the target area percentage began to decline in 72 hours after exercise group (P<0.05), which was higher than quiet control level. After exhaustive eccentric exercise, cytoskeletal vimentin begin to express at varying degrees. The vimentin expression is increased gradual y at 12 hours and reached the peak at 48 hours, then begins to decrease.

Clinical analysis of combined surgery on 68 patients with refractory glaucoma and coexisting cataract / 中国医师杂志

Objective To explore clinical application of the combined therapy of manual small incision cataract surgery (MSICS) with intraocular lens (IOL) implantation and trabeculectomy for patients with refractory glaucoma and coexisting cataract.Methods In our hospital,68 patients (76 eyes) with angle-closure glaucoma of continuously high intraocular pressure (lOP) and coexisting cataract were included in this study from April 2008 to October 2011.All of them were treated with the combination of MSICS with IOL implantation and trabeculectomy.Postoperative visual acuity,IOP,anterior chamber depth (ACD),filtering bleb,ocular fundus and complications were observed.Results Each operation was successfully completed.Postoperative visual acuity and IOP were significantly improved and decreased,respectively,compared to the preoperative.ACD was deepen and filtering bleb was effectively established in the postoperative eyes without significant complications.Conclusion The combined surgery of MSICS with IOL implantation and trabeculectomy might effectively increase visual acuity and decrease IOP,which was a safe and effective approach for patients with refractory glaucoma and coexisting cataract.

Effect of 6% hydroxyethyl starch 130/0.4 and Ringer's solution resuscitation on early lung injury in hemorrhagic shock rats / 中国药理学通报

Aim To investigate the effects of 6% hydroxyethyl starch 130/0.4(6%HES 130/0.4)and Ringer's solution resuscitation on early lung injury in hemorrhagic shock rats and its mechanisms.Methods Twenty-four male SD rats were divided into 4 groups:sham,Ringer's solution(RS),two HES groups(H1,H2).Group H1,H2 received HES 33,50 ml·kg~(-1) and Ringer's solutions respectively after 90-minute shock(the dose of Ringer's solutions was 3 times as muchas the maximum shed blood volume minus the dose of HES).Blood samples were taken from artery for blood analysis and the expression of CD11b/CD18 at T_0,T_1,T_4,T_5.The lungs were removed for ultrastructure examination.Results PaO_2 increased in group H1 at T_(1～5) and group H2 at T_5 as compared with T_0.PaCO_2 decreased in all the resusitation groups.The ultrastructure was basically normal except that the mitochondria changed slightly in group H1.In group H2,the perinuclear space was dilated slightly and the rough endoplasmic reticulum expanded slightly,and the degranulation was observed.Compared with group RS,the expressions of CD11b and CD18 decreased at T_4,T_5;compared with group H1,the expressions of CD11b and CD18 in group H2 increased.Conclusions Treatment with 6%HES(130/0.4)33 ml·kg~(-1)and Ringer's solution can attenuate hemorrhagic shock,and the resuscitation reduces lung injury through inhibition of expressions of CD11b and CD18.

Effects of volume therapy with different doses of 6% hydroxyethyl starch 130/0.4 on lung injury in a rat model of hemorrhagic shock / 中华麻醉学杂志

Objective To evaluate the effects of volume therapy with different doses of 6% hydroxyethyl starch 130/0.4 (6% HES 130/0.4) on lung injury in a rat model of hemonhagic shock.Methods Twenty-four male SD rats weighing 220-300 g were randomly divided into 4 groups ( n = 6 each) : group I sham operation (group S); group II Ringer's solution (group RS); group HI and IV 2 HES groups (group H1, H2 ). The animals were anesthetized with intraperitoneal 1% sodium pentobarbital 45 ing/kg. Right common carotid artery (CCA) and left femoral vein were cannulated for blood letting, MAP monitoring, fluid administration and blood sampling. Hemonhagic shock was induced by withdrawing blood from right CCA in group II , III and IV . MAP was reduced to 35-45 mmHg which was maintained for 90 min. In group RS, hemorrhagic shock was resuscitated with Ringer's solution 3 times of the volume of blood withdrawn, while group H1 and H2 received HES 33 and 50 ml/kg respectively and Ringer' s solution (the total volume was equal to 3 times of the volume of blood removed) . Arterial blood samples were taken before blood letting (T0 , baseline), and at 2, 3 h after volume therapy (T1,2) for blood gas analysis and PaO2/FiO2 was calculated. The animals were then sacrificed by exsanguination and the lungs were immediately removed for microscopic examination and determination of protein concentration in broncho-alveolar lavage fuid (BALF), W/D lung weight ratio and TNF-α, IL-1 β and IL-10 contents in the lung.Results TNF-α, IL-1β and IL-10 content in the lung, protein concentration in BALF and W/D ratio were significantly higher in group RS, H1 and H2, while PaO2/FiO2 was significantly lower at T,2 in group RS and at T2 in group H2 than in group S (P < 0.05). TNF-α and IL-1β contents in the lung, protein concentration in BALF and W/D ratio were significantly lower in group H1 and H2 , while PaO2/FiO2 was significantly higher at T,i2 in group H1 and at T1 in group H2 than in group RS (P <0.05) . PaO2/FiO2 at T2 and IL-10 content in the lung were significantly lower in group H2 than in group H, ( P < 0.05) . The lung damage was significantly ameliorated in group H1 and H2 especially in group H, as compared with group RS. Conclusion Volume therapy with 6% HES 130/0.4 33 or 50 ml/kg can attenuate lung injury in a rat model of hemorrhagic shock and the efficacy of 33 ml/kg is better.

The interventional evaluation and management of arteriovenous fistulae in patients with hepatic cancer / 介入放射学杂志

Objective To analyze the DSA manifestations of arteriovenous fistulae in hepatic cancer and to discuss the appropriate method for obstructing the fistulae in order to improve the therapeutic results for hepatic cancer associated with arteriovenous fistulae. Methods The imaging findings in 183 patients of hepatic cancer with urteriovenous fistulae, which were. selected from 637 patients with liver cancer, were retrospectively analyzed. For cases with mild arteriovenous fistulae (n = 89) the tumor-feeding arteries were embolized after iodized oil embolization procedure, while for cases with moderate and severe aneriovenous fistulae (n = 94) the abnormal shunts were obstructed before performing chemoembolization of the tumor in order to ensure that the effective infusion of the drug into the lesion and the sufficient deposit of iodized oil in the tumor could be obtained. Results The tumor-feeding arteries were successfully embolized in all 89 patients with mild arteriovenous fistulae. Of 94 cases with moderate and severe arteriovenous fistulae,excellent deposit of iodized oil was seen in 64 (68.1%), incomplete embolization in 13 (14.83%), poor oil deposit due to over-embolization in 11 (11.7%) and failure to block the fistulae as the fistulae were too large or too diffuse in 6 (6.4%). No serious complications occurred. Conclusion The arteriovenous fistulae accompanied with hepatic cancer can be effectively obstructed in most patients, with resultant clinical improvement of the patients' condition. This therapeutic technique is safe and reliable.

Allograft decalcified bone matrix combined with autologous bone marrow stromal cells for repairing articular cartilage defects in rabbits / 中国组织工程研究

BACKGROUND: Demineralized bone matrix (DBM) having a great biocompatibility is a common material to repair bone defect in clinic Bone marrow stromal cells (BMSCs) which can differentiate into bone and cartilage cells are ideal for repairing cartilage defect. OBJECTIVE: To observe the effects of allograft DBM combined with autograft BMSCs on repairing the articular cartilage of rabbits. METHODS: Bone and cartilage defect was induced in 27 rabbits and the models were randomly divided into combined group (DBM combined with 8-day-curtured autograft BMSCs), DBM group (DBM implantation alone), and control group. The reparative tissue samples were evaluated grossly, histologically, and immunohistochemically. The repairing effect was evaluated by Wakitani's score system.RESULTS AND CONCLUSION: The repaired tissues were hyaline cartilage-shaped, smooth and glossy, and well combined with peripheral cartilage and subchondral tissues at 12 weeks after implantation in the combined group; some tissues were cartilage-likely repaired in the DBM group; a few of tissues were fiber-like repaired in the control group. Immunohistochemical staining showed that type Ⅱ collagen was positive in both combined and DBM groups. Repaired cells which could express type Ⅱ collagen were cartilage cells. However, the expression of type Ⅱ collagen was negative in the control group. At 4,8, and 12 weeks after implantation, the scores in the combined group were significantly higher than in the DBM and control groups (P < 0.01), suggesting that DBM/BMSCs complex could be an efficient graft to repair the articular cartilage defects.

Proliferation of rabbit bone marrow stromal stem cells on varying degrees of decalcified bone matrix materials / 中国组织工程研究

BACKGROUND: Demineralized bone matrix (DBM) has natural mesh pores, good plasticity and biocompatibility. However, the decalcification time in preparation of DBM remains controversial.OBJECTIVE: To compare effects of varying degrees of decalcification with DBM on the proliferation of bone marrow stromal stem cells (BMSCs) so as to provide the best DBM scaffold for cartilage tissue engineeringMETHODS: Rabbit iliac bones were prepared into strips, defatted, followed by 6,12 and 24 hours of decalcification and 2 days of soaking in alcohol to prepare DBM. DBMs were placed in 24-well plates. The third passage of BMSCs at a density of 5×10~9/L were incubated on 24-well plate with DBMs. The DBM porosity and pore size were observed by scanning electron microscopy;BMSCs proliferation on the DBM was determined by MTT, and cell attachment on DBM was observed by scanning electron microscopy.RESULTS AND CONCLUSION: DBM displayed natural high-density porous grid structure, in the presence of bone trabecula,trabecular space and bone luminal system. The porosity and pore size of DBM decalcified for 6,12 and 24 hours were similar (P > 0.05). Compared with decalcified for 12 and 24 hours, BMSCs attached to DBM decalcified for 6 hours more closely and the DBM showed better compatibility. SEM observation showed the BMSCs on DBMs decalcified for 6 hours proliferated stably after 8 days and applicable for transplantation. Moreover, the number of cells were significantly more than DBMs decalcified for 12 and24 hours (P< 0.01).