Transjugular intrahepatic portosystemic shunt versus surgical shunting in the management of portal hypertension / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The purpose of this article was to clarify the optimal management concerning transjugular intrahepatic portosystemic shunts (TIPSs) and surgical shunting in treating portal hypertension.</p><p><b>METHODS</b>All databases, including CBM, CNKI, WFPD, Medline, EMBASE, PubMed and Cochrane up to February 2014, were searched for randomized controlled trials (RCTs) comparing TIPS with surgical shunting. Four RCTs, which were extracted by two independent investigators and were evaluated in postoperative complications, mortality, 2- and 5-year survival, hospital stay, operating time and hospitalization charges.</p><p><b>RESULTS</b>The morbidity in variceal rehemorrhage was significantly higher in TIPS than in surgical shunts (odds ratio [OR] = 7.45, 95% confidence interval[CI]: (3.93-14.15), P < 0.00001), the same outcomes were seen in shunt stenosis (OR = 20.01, 95% CI: (6.67-59.99), P < 0.000001) and in hepatic encephalopathy (OR = 2.50, 95% CI: (1.63-3.84), P < 0.0001). Significantly better 2-year survival (OR = 0.66; 95% CI: (0.44-0.98), P = 0.04) and 5-year survival (OR = 0.44; 95% CI: (0.30-0.66), P < 0.00001) were seen in patients undergoing surgical shunting compared with TIPS.</p><p><b>CONCLUSIONS</b>Compared with TIPS, postoperative complications and survival after surgical shunting were superior for patients with portal hypertension. Application of surgical shunting was recommended for patients rather than TIPS.</p>

Glucocorticoids Significantly Influence the Transcriptome of Bone Microvascular Endothelial Cells of Human Femoral Head / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Appropriate expression and regulation of the transcriptome, which mainly comprise of mRNAs and lncRNAs, are important for all biological and cellular processes including the physiological activities of bone microvascular endothelial cells (BMECs). Through an intricate intracellular signaling systems, the transcriptome regulates the pharmacological response of the cells. Although studies have elucidated the impact of glucocorticoids (GCs) cell-specific gene expression signatures, it remains necessary to comprehensively characterize the impact of lncRNAs to transcriptional changes.</p><p><b>METHODS</b>BMECs were divided into two groups. One was treated with GCs and the other left untreated as a paired control. Differential expression was analyzed with GeneSpring software V12.0 (Agilent, Santa Clara, CA, USA) and hierarchical clustering was conducted using Cluster 3.0 software. The Gene Ontology (GO) analysis was performed with Molecular Annotation System provided by CapitalBio Corporation.</p><p><b>RESULTS</b>Our results highlight the involvement of genes implicated in development, differentiation and apoptosis following GC stimulation. Elucidation of differential gene expression emphasizes the importance of regulatory gene networks induced by GCs. We identified 73 up-regulated and 166 down-regulated long noncoding RNAs, the expression of 107 of which significantly correlated with 172 mRNAs induced by hydrocortisone.</p><p><b>CONCLUSIONS</b>Transcriptome analysis of BMECs from human samples was performed to identify specific gene networks induced by GCs. Our results identified complex RNA crosstalk underlying the pathogenesis of steroid-induced necrosis of femoral head.</p>

A method for isolated culture of bone microvascular endothelial cells of human femoral head / 中国骨伤

<p><b>OBJCETIVE</b>To investigate the method of separation of culture of bone microvascular endothelial cells (BMECs) of human femoral head in vitro.</p><p><b>METHODS</b>From October 2013 to January 2014,15 femoral heads without pathologic change from patients resected during hip replacement were selected involving 2 males and 13 females with a mean age of 71.2 years old ranging from 38 to 92. Cancellous bone in femoral head was bited into broken bone grain and transfered into medium in aseptic contidion. Cells were isolated by the methods of enzymic digestion and density gradient centrifugation,purified by differiential attachment. The characteristics of cells was observed by inverted microscope. vWF and CD31 immunofluorescence analysis was applied for identification of cells.</p><p><b>RESULTS</b>The number of cells was positively correlated with patients' age after 24 hours in primary culture. The older patients had the less cells numbered. After 4 to 5 days' culture, primary cells appeared short spindle,polygon shaped and cobblestone-like morphology. After 7 to 10 days' culture, primary cells proliferated densely, became fusion, arranged in swirl, and contact inhibition appeared significantly. Immunofluorescence staining revealed the cells were 100% positive for vWF and CD31, and it showed that the cultured cells were BMECs.</p><p><b>CONCLUSION</b>It was a simple, steady, effective method with good reproducibility, by which highly purified human BMECs can be obtained.</p>

Effect of qihuang decoction on mRNA expressions of Bcl-2, Bax, and Caspase-3, 9 in intestinal mucosa epithelium of ischemia/reperfusion injured rats / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Qihuang Decoction (QHD) on mRNA expression of apoptosis genes Bcl-2, Bax, and signal transduction molecules Caspase-3, 9 in intestinal mucosa epithelium of ischemia/ reperfusion (I/R) injured rats.</p><p><b>METHODS</b>Forty Wistar rats were randomized equally into 4 groups, the control group, the model group, the glutamine group, and the QHD group. Rats in the latter two groups were gastric infused with glutamine and QHD respectively for 3 days, but saline was infused instead to rats in the control group and model group. After then, except those in the control group intervened only by sham operation, rats were made into I/R injured model by 45 min occlusion of superior mesenteric artery followed by 1 h reperfusion. Immediately after modeling, mRNA expressions of Bcl-2, Bax, Caspase-3, and Caspase-9 in intestinal mucosa epithelium of rats were detected by reverse transcription-polymerase chain reaction (RT-PCR).</p><p><b>RESULTS</b>Compared with the control group, mRNA expressions of Bcl-2, Bax, Caspase-3 and Caspase-9 were higher in the other three groups (P < 0.05). Compared with the model group, Bcl-2 mRNA expression was higher, while the expressions of the other three indices were lower in both the glutamine group and the QHD group (P < 0.05); and comparisons between the glutamine group and the QHD group showed a more depressed Bax mRNA expression (0.281 +/- 0.087 vs 0.350 +/- 0.053) and higher Bcl-2/Bax ratio (1.648 vs 1. 374) in the QHD group.</p><p><b>CONCLUSIONS</b>QHD can reduce the I/R injury in the intestinal mucosa epithelium by inhibiting the cell apoptosis. The mechanism may be correlated with increased Bcl-2 mRNA expressions and decreased mRNA expressions of Bax, Caspase-3 and Caspase-9.</p>

Effect of qihuang decoction on epithelial cell apoptosis of ischemia/reperfusion injured intestinal mucosa in rat / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Qihuang Decoction (QHD) on epithelial cell apoptosis of ischemia-reperfusion (I/R) injured intestinal mucosa in rat.</p><p><b>METHODS</b>The I/R injured intestinal mucosa rat model was established by clamping superior mesenteric artery (SMA) for 45 min and reperfusing for 60 min. The pathomorphological Changes and epithelial cell apoptosis in the injured intestinal mucosa were observed and compared among groups: the sham-operated group (A), the model group (B), the glutamine treated group (C) and the QHD treated group (D).</p><p><b>RESULTS</b>pathomorphological examination showed that in group A, the intestinal villus was intact; in group B, the intestinal subepithelial space were dilated, and showed evident cleavage between the epithelial top and the lamina propria with bare capillaries, bleeding and ulceration; in group C and D, the above-mentioned pathomorphological changes were alleviated to some extents, appeared only in part of the villa, and the alleviation was more significant in group D than in group C. Chiu's scoring showed that the lowest score (zero) presented in group A and the highest presented in group B; scores in group C and D was significantly lower than that in group B (P < 0.05), but showed insignificant difference between the two groups (P > 0.05). Epithelial cell apoptosis detection showed that the least apoptosis rate presented in group A, and the highest in the group B; while in the group C, it lied between group A and B (all P < 0.05), and showed no statistical significance to group D (P > 0.05), though appeared a lowering trend.</p><p><b>CONCLUSION</b>QHD could reduce the I/R injured intestinal epithelial mucosa, and its protective mechanism may be related to the inhibition on apoptosis of intestinal mucosal epithelial cells.</p>

Effect of early intestinal dripping of jianpi tongli Chinese herbs on serum level IL-2, sIL-2R and IL-12 in patients with gastric cancer after operation / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the regulation and clinical significance of intestinal dripping of Jianpi Tongli (JPTL) Chinese herbs on levels of serum cytokines, such as interleukin-2 (IL-2), soluble interleukin-2 receptor (sIL-2R) and interleukin-12 (IL-12) in treating patients with gastric cancer (GC) at early post-operational stage.</p><p><b>METHODS</b>Sixty patients with GC were randomly divided into two groups, i. e. the studied group (n = 30), treated with JPTL Chinese herbs, and the control group (n = 30) treated with normal saline. The medication was started from the 1st day after operation by intestinal dripping daily, 7 days as one course. Levels of IL-2, sIL-2R and IL-12 were observed before and after operation.</p><p><b>RESULTS</b>Significant difference was seen on the 7th day post-operation between the studied and the control group, mainly in aspects of obvious increase of IL-2 and decrease of sIL-2R (P <0.05), no significant difference in IL-12 was found (P >0.05) though there was certain improvement. Compared with pre-operation of the same group, significant difference was found in the studied group in the increased IL-2 and IL-12 and decreased sIL-2R on the 7th day post-operation, while no significant difference in these indexes was found in the control group (P >0.05), though certain improvement was shown.</p><p><b>CONCLUSION</b>Early intestinal dripping of JPTL Chinese herbs to post-operational patients with GC could improve their immune function, which was of important significance in early preventing the severe complications, improving the prognosis, and elevating the survival rate.</p>