Preliminary discussion on the causes and influencing factors of blood discarding / 中国输血杂志

【Objective】 To conduct a retrospective statistical analysis of the blood discarding situation in Xuzhou Central Blood Station in the past 5 years, so as to explore relevant measures and strategies to reduce blood discarding and save blood resources. 【Methods】 The discarding situation of our station from 2018 to 2022 was systematically sorted out, and Big data analysis base on the two causes, which was unqualified testing and non unqualified testing, was conducted. 【Results】 The total blood discarding rate of our station from 2018 to 2022 was 9.57% (94 273/985 178), and there was a difference in the total discarding rate between different years (Panti-TP(0.23%, 2 263/985 178)>anti-HCV(0.14%, 1 354/985 178)> HBsAg(0.13%, 1 285/985 178)>anti-HIV (0.12%, 1 140/985 178). The unqualified rate of ALT in males (0.63%, 1 993/317 437) was significantly higher than that in females (0.19%, 388/209 601) (P<0.05). The unqualified rate of ALT at the age of 18-25 accounted for 55% (0.49/0.89) of the total unqualified rate of ALT, and was significantly higher than other age groups (P <0.05). 【Conclusion】 It is suggested to improve the public awareness of voluntary blood donation, strengthen health consultation before blood donation, promote staff training so as to reduce blood discarding rate, as well as ensure sufficient, safe and effective clinical blood use.

Research progress in complications and their prevention and treatment strategies during extracorporeal membrane oxygenation support for severe trauma / 中华创伤杂志

Extracorporeal membrane oxygenation (ECMO) is a technique in which breathing and circulation are supported extracorporeally. Severe trauma may induce cardiopulmonary failure, for which ECMO can play an adjunctive role in the salvage treatment of circulatory and respiratory failure when conventional treatments are ineffective. Bypass with ECMO can rapidly improve the state such as circulatory failure and hypoxemia in critically ill patients in short term and can partially or fully replace their cardiopulmonary function in long term, winning valuable time for normal recovery of cardiopulmonary function. Because of the physical state of severe trauma patients and the ECMO equipment, there are still various complications clinically. Trauma patients show high risk of bleeding, vulnerability to wound infection and probability of combined organ injury and dysfunction, so more comprehensive measures for the prevention and treatment of complications during the use of ECMO therapy are required. The authors review the research progress in complications and corresponding prevention and treatment strategies during ECMO support for severe trauma, aiming to provide a reference to prevent and treat these complications.

A study on the clinical application of different diagnostic criteria for bronchopulmonary dysplasia / 中国新生儿科杂志

Objective:To compare the results of clinical diagnosis and severity grading in preterm infants with bronchopulmonary dysplasia (BPD) using three different diagnostic criteria and the consistency of two new diagnostic criteria.Methods:From January to December, 2020, infants with gestational age <32 w admitted to neonatal intensive care unit of our hospital were retrospectively enrolled in this cohort study. The patients were diagnosed and graded according to the 2001, 2018 and 2019 criteria of BPD. Chi-square test was used to compare the differences of BPD diagnostic rate and mortality rate using three criteria and Kappa coefficient test was used to compare the consistency between the two new criteria of 2018 NICHD and 2019 NRN.Results:A total of 231 preterm infants were enrolled, including 130 males (56.3%) and 101 females. 9 patients were dead. According to 2018 NICHD criteria, 97 cases (42.0%) were diagnosed with BPD, including 16 gradeⅠ, 44 grade Ⅱ, 31 grade Ⅲ and 6 grade ⅢA. The remaining 134 cases were not BPD (58.0%). No significant differences existed ( P>0.05) among the diagnostic rates of 2001 criteria (112/231, 48.5%), 2018 criteria (97/231, 42.0%) and 2019 criteria (91/231, 39.4%). For grade Ⅲ BPD, the diagnostic rate of 2001 criteria was significantly higher than the 2018 criteria (including grade Ⅲ and grade ⅢA, 16.0%) and 2019 criteria (6.5%) and the diagnostic rate of 2018 criteria was also significantly higher than 2019 criteria ( P<0.05). No significant differences existed in the overall mortality rate of BPD among three criteria ( P>0.05), however, the case mortality rate of grade Ⅲ BPD of 2001 criteria (3.9%) was significantly lower than 2018 criteria (24.3%) and 2019 criteria (20.0%) ( P<0.05). The 2018 and 2019 criteria were highly consistent in the overall diagnostic rate of BPD (Kappa value = 0.946), the positive consistency rate was 93.8% (95% CI 85.5%~97.5%) and the negative consistency rate was 100.0% (95% CI 96.5%~100.0%). But the consistency of severity grading for BPD was weak (Kappa value = 0.597) between the two criteria. Conclusions:The 2001 NICHD BPD criteria is no longer valid because it tends to overdiagnose severe BPD, thus underestimate the case mortality. The 2018 NICHD criteria is comprehensive and detailed and the 2019 NRN criteria is simple and practical. The two new criteria are highly consistent in the overall diagnosis of BPD, but the consistency of severity grading is weak.

Clinical guideline on first aid for blast injury of the chest (2022 edition) / 中华创伤杂志

Blast injury of the chest injury is the most common wound in modern war trauma and terrorist attacks, and is also the most fatal type of whole body explosion injury. Most patients with severe blast injury of the chest die in the early stage before hospitalization or during transportation, so first aid is critically important. At present, there exist widespread problems such as non-standard treatment and large difference in curative effect, while there lacks clinical treatment standards for blast injury of the chest. According to the principles of scientificity, practicality and advancement, the Trauma Society of Chinese Medical Association has formulated the guidance of classification, pre-hospital first aid, in-hospital treatment and major injury management strategies for blast injury of the chest, aiming to provide reference for clinical diagnosis and treatment.

Quality of cryoprecipitated antihemophilic factor: Impact of storage time following whole blood collection, gender, ABO blood group, age, and preparation method / 中国输血杂志

【Objective】 To investigate the factors affecting the quality of cryoprecipitated antihemophilic factor. 【Methods】 The quality test results of cryoprecipitated antihemophilic factor in Xuzhou Central Blood Station from 2017 to 2020 were selected and compared. The fresh frozen plasma (FFP) was stratifying by storage time following whole blood collection: less than 2h, 2~4 h, 4~6 h, and 6~8 h; by gender: males and females; by blood group: A, B, O, and AB groups; by age: 18~30, 30~45, and 45~60 ages; by preparation method: centrifugation and siphonage. The contents of fibrinogen (FIB) and factor Ⅷ in cryoprecipitated antihemophilic factor in each group were compared. 【Results】 The content of FIB and factor Ⅷ in females were higher than those in males(P<0.05). The content of factor Ⅷ differed statically by blood groups (P<0.05), which was lower in group O than others [graup A(180.5±75.2)IU, graup B(155.1±59.4)IU, graup O(109.3±46.4)IU, graup AB(168.5±65.1)IU]. The content of factor Ⅷ increased with age statistically (P<0.05). The content of FIB prepared by centrifugation [(373.3±126.1)mg] was superior to siphonage [(309.4±85.6)mg] (P<0.05), while the content of factor Ⅷ prepared by siphonage [(172.4±71.3)IU] was superior to centrifugation [(124.0±49.1)mg] (P<0.05). 【Conclusion】 Gender and preparation method are the influencing factors of FIB. Gender, age, blood group and preparation method are the influencing factors of the content of factor Ⅷ. The FFP prepared by whole blood preserved with the ACD (citrate, sodium citrate and glucose) solution at any time within 8h after the collection has no impact on the quality of cryoprecipitated antihemophilic factor.

Spatial distribution and molecular identification of small mammals in the areas of natural focus disease in Qinghai Province / 中华地方病学杂志

Objective:To understand the spatial distribution of small mammals in the areas of natural focus disease in Qinghai Province, and to identify captured small mammals at the molecular level using mitochondrial cytochrome C oxidase subunit I (COI) gene as molecular marker.Methods:In 2009 - 2016, the distribution of regional spatial, elevation distribution and ecological environment type of captured small mammals were analyzed in 16 cities (counties) of 6 prefectures in Qinghai Province. The partial COI gene fragment sequence (about 650 bp in length) was obtained by PCR amplification, which was further analyzed through homology comparison, genetic distance and phylogenetic analysis.Results:Totally 1 631 small mammals were captured that had belonged to 30 species of 21 genera, 7 families, 3 orders. Among them there were 926 rodent animals that had belonged to 25 species of 19 genera, 5 families, accounting for 56.78%. There was the largest number in Golmud (313 animals), the highest distribution of small mammals was found at the elevation of 2 800 - < 3 000 m (532 animals), the largest number of small mammals was found in the sandy grassland (612 animals). COI genes of 292 small mammals were successfully amplified, and the homology was consistent with the target sequence. The results showed that the intraspecific genetic distance ranged from 0.01% to 2.90%, interspecific genetic distance ranged from 4.00% to 12.00%, intergenus genetic distance was 13.00% - 21.00% and interfamily genetic distance was 22.00% - 25.00%. The interspecific genetic distance was significantly greater than the intraspecific genetic distance. Neighbor-Joining tree showed that the same species were clustered into a single branch with high support form a total of 20, with a confidence level of 98% to 100%.Conclusions:The spatial distribution of small mammals is influenced by geographical factors such as region, elevation and ecological environment in Qinghai Province. Molecular identification can make up for the shortcomings in morphological identification.

Effect of exogenous hydrogen sulfide on iNOS/NO in neonatal rats with hyperoxia lung injury / 中国新生儿科杂志

Objective To study the effect of hydrogen sulfide (H2S) on iNOS/NO in neonatal rats with hyperoxia-induced lung injury.Method Eighty full-term neonatal SD rats were randomly assigned into 4 groups (each group 20 rats including control group,hyperoxia group,NaHS + hyperoxia group,PPG + hyperoxia group.Rats in NaHS + hyperoxia group had 90 μmol/kg NaHS injected intraperitoneally,those in PPG + hyperoxia group had PPG 50 mg/kg injected,and those in the other 2 groups had the same amount of 0.9％ normal saline injected.Except for the control group that exposed to air,the other three groups were exposed to 95％ O2 for 7 days.Then pulmonary histopathology was studied by HE staining,the ratios of lung wet/dry weight (W/D) were determined as measurement of the severity of pulmonary edema,maleic dialdehyde (MDA),iNOS activity and NO levels in lung tissue were measured using commercial kits,iNOS mRNA expression was detected by Real-time PCR.Analysis of variance and LSD-t test were used for statistical analysis.Result (1) Compared with control group,the hyperoxia group showed erythrocyte extravasation and leukocyte infiltration in the alveoli with inflammatary cell infiltrations,alveolar septum edema,whereas pathological injury changes induced by hyperoxia were alleviated by NaHS and the damage was exacerbated by PPG.(2) In hyperoxia group,H2S was decreased compared with control group (117.6±20.4 μmol/L vs.184.3 ± 13.7 μmol/L).In NaHS + hyperoxia group,H2S was apparently increased compared with the hyperoxia group (247.3 ±32.4 μmol/L vs.117.6 ±20.4 μmol/L),while in PPG + hyperoxia group H2S was decreased compared with the hyperoxia group (89.2 ± 8.3 μmol/L vs.117.6 ±20.4 μmol/L) (P ＜0.01).(3) In the hyperoxia group,the ratios of lung W/D (5.81 ±0.22),the contents of MDA (1.69 ± 0.14) nmol/ml,iNOS activity (2.24 ± 0.19) U/mg prot,NO levels (22.37 ±3.04) × 10-3 μmol/g prot,iNOS mRNA expression (1.43 ±0.09) showed significant increase respectively (P ＜ 0.01) compared with the control group (5.06 ± 0.15),(0.78 ± 0.08)nmol/ml,(1.18 ± 0.18) U/mg prot,(7.49 ± 1.91) × 10-3 μmol/g prot,(0.90 ± 0.08).NaHS administration showed a significant decrease in lung W/D,lung tissue MDA content,iNOS activity,NO level,iNO SmRNA expression (5.59 ±0.19),(1.44±0.11) nmol/ml,(1.84 ±0.27) U/mg prot,(14.23 ±2.00)× 10-3 μmol/g prot,(1.28 ±0.10) compared with the hyperoxia group (P ＜0.01).The above markers were significantly increased after PPG administration (6.18 ± 0.26),(1.99 ± 0.19) nmol/ml,(2.66 ± 0.23) U/mgprot,(30.94 ±3.31) × 10-3 μmol/g prot,(1.73 ±0.06) (P ＜0.01).Conclusion Exogenous H2S can relieve hyperoxia-induced lung injury by down-regulating the expression of iNOS mRNA,decreasing iNOS activity and decreasing NO production.

Molecular identification of main vector fleas in Qinghai plague foci by DNA barcoding / 中华地方病学杂志

Objective To make up the limitations of traditional morphological classification methods,we identified vector fleas by DNA barcoding in Qinghai Province.Methods The mt DNA cytochrome c oxidase subunit Ⅰ (CO Ⅰ) gene was amplified by PCR from 36 muscle tissues of fleas in 3 states,2 cities and 5 counties of Qinghai Province,and the obtained CO Ⅰ gene fragments were sequenced and aligned.The intra-and inter-species genetic distances were calculated with Mega 6 software using K2-P model and a phylogenetic tree was constructed with neighbor-joining (NJ) method.Results Totally 36 CO Ⅰ gene sequences of 2 superfamilies,4 genera and 6 kinds of vector fleas were measured,the average genetic distance was 0.119,and the intraspecific distance was 0.002-0.027,the interspecific distance was 0.039-0.207,and the interspecific genetic distance was significantly greater than the intraspecific genetic distance.NJ tree showed the same species had formed a single line with high support rate and interspecific branch was clear.Conclusion DNA barcoding is suitable for identification of vector fleas in Qinghai Province,may make up the limitations of traditional morphological classification methods.

The clinical application of mirabilite abdominal hot compression bag for treating acute pancreatitis / 中华胰腺病杂志

Objective To explore the clinical application of mirabilite abdominal hot compression bag designed by ourselves for the moderately severe acute pancreatitis ( MSAP ) or severe acute pancreatitis ( SAP) .Methods Seventy MSAP and SAP patients were randomly divided into the observed and control groups according to the admission date.Each group included 35 patients.All the patients received the routine treatment.The patients in observed group received the treatment of compression action on abdomen by mirabilite abdominal continual hot compression bag designed by ourselves, while the traditional mirabilite hot compression action was used in the control group.The APACHEⅡscore and the levels of plasma CRP, IL-1, IL-6 and TNF-αof all patients on the 1st, 3rd, 6th, and 9th day after being admitted, the rate of complications including the intra-abdominal hypertension (IAH), pancreatic pseudocysts (PPC) and pulmonary infection, the recovery time of intestinal function and mean hospitalization time were all recorded and the therapeutic efficacy was compared between the two groups.Furthermore, the therapeutic effects of MSAP and SAP were compared between two groups.Results The APACHEⅡscore and the levels of plasma CRP, IL-1, IL-6 and TNF-αwere not statistically different between the two groups on the 1st day after hospitalization.The APACHEⅡscore and the levels of plasma CRP, IL-1 and TNF-αon the 3rd day in the observed group were significantly lower than those in the control group(P<0.05 or <0.01).The APACHEⅡ score and the levels of plasma CRP, IL-1 , IL-6 and TNF-αon the 6th day in the observed group were significantly lower, comparing to those in the control group.The levels of serum IL-1 and TNF-αin the observed groups were significantly lower than those in control group on the 9th day.All the differences above were statistically significant ( P<0.05 or <0.01).In the observed group, 4 cases (11.4%) had IAH and 7 cases (20.0%) developed other complications.The time of intestinal recovery and mean hospitalization was (4.9 ±0.8)d and (13.1 ±2.1)d, respectively, in the observed group.In the control group, 11 cases (31.4%) had IAH and 10 cases (28.6%) had other complications, and the time of intestinal recovery and mean hospitalization was (5.5 ±0.8) d and (15.4 ±3.9)d,respectively,.The rate of IAH, intestinal function recovery time and hospitalization time in the observed group were significantly less than those in control group (P<0.05 or <0.01).There was no statistical difference on other complications between the two groups.The intestinal function recovery time and hospitalization time of MSAPs in the observed group were significantly less than those in control group [(5.0 ± 0.8)d vs (5.5 ±0.8)d, P=0.03; (12.7 ±1.7)d vs (15.2 ±3.6)d, P=0.02].The APACHEⅡ score and the levels of plasma CRP, IL-1, IL-6 and TNF-αof SAPs were not statistically different between the two groups.Conclusions The application of the mirabilite abdominal continual hot compression bag could alleviate inflammatory response of MSAP and SAP, decrease the rate of IAH, improve the intestinal function recovery time,and shorten the hospitalization time.

Effect of early nasogastric tubing bile reinfusion on gastrointestinal function recovery for patients undergoing laparoscopic bileduct operation / 中国实用护理杂志

Objective To explore the effect of early nasogastric tubing bile reinfusion on gastrointestinal function recovery for patients undergoing laparoscopic bileduct operation.Methods One hundred patients undergoing laparoscopic bileduct operation were divided into observation group and control group with 50 cases each by random digits table method.The control group received routine nursing,and the observation group received early nasogastric tubing bile reinfusion on the basis of routine nursing.The recovery of postoperative gastrointestinal function and the incidence of postoperative abdominal distention between the two groups were observed and compared.Results The length of time needed for intestinal voice restoration and exhausting were (17.12 ± 3.88),(33.92 ± 8.96) h in observation group,and (24.08 ± 7.25),(43.64 ± 11.18) h in control group,and the differences were statistically significant (t =5.99,4.80,P ＜ 0.01).The incidence of postoperative abdominal distension was 22％(11/50) in observation group,and 42％(21/50) in control group,and the difference was statistically significant (x2=4.60,P＜ 0.05).Conclusions The early nasogastric tubing bile reinfusion in patients undergoing laparoscopic bileduct operation can effective promote their gastrointestinal function recovery and reduce the occurrence of postoperative abdominal distension.

Monitoring results of human brucellosis in Qinghai Province in 2014 / 中华地方病学杂志

Objective We analyzed the epidemiological survey results of brucellosis in Qinghai Province to study the distribution of area,population and occupation of brucellosis in human.Methods In accordance with The Project of Central Tansfer Local Public Health Funds-Detailed Rules for Human Brucellosis Control in Qinghai Province in 2014,one city and 9 counties were chosen to carry out the human brucellosis investigation which focused on the people closely contacted with animals and their produces in Qinghai Province;then serological test was done with the methods of Rose Bengal plate agglutination test (RBPT) and standard tube agglutination test (SAT);diagnosis was based on Diagnostic Criteria for Brucellosis (WS 269-2007).Results A total of 3 083 people in the 9 counties and 1 city were investigated;totally infected people was 96,the infection rate was 3.11％;the number of patients was 46,and the prevalence rate was 1.49％.Forty-six new cases were confirmed.The gender,age distributions of the infection rate and prevalence rate were not significantly different (x2 =1.766,2.236,11.053,10.160,all P ＞ 0.05).The occupational distribution:pastoralist was the highest,accounting for 73.91％ (34/46);ethnic distribution:Tibetan was the highest,accounting for 73.91％ (34/46).In addition to Maqin,other counties had brucellosis patients.Conclusions Prevalence of human brucellosis in Qinghai Province is active in some local areas.We should strengthen health education and professional intervention in occupational populations;to improve people's ability in prevention and control of the disease,further investigation and analysis of the source of infection and risk factors in areas where infected persons and patients on the rise are needed,and make progress in control of human brucellosis outbreaks in Qinghai Province.

Analysis of an investigation result of human Brucellosis in Qinghai Province in 2012 / 中华地方病学杂志

Objective Though analyzing the epidemiological trend of human Brucellosis in Qinghai Province in 2012, to provide a advice for Brucellosis prevention and control. Methods Brucellosis investigation was carried out on key populations aged 7-60 years who were keeping in touch with livestock in Ping’an County, Haiyan County, Tianjun County, Dari County, Jiuzhi County, Henan County, and three or four towns were selected as investigation sites in each county; then serological test was done with the methods of the rose bengal plate agglutination test(RBPT), standard tube agglutination test(SAT) and Coombs; diagnosis was based on “Diagnostic Criteria for Brucellosis”( WS 269-2007 ) . Results A total of 4 253 people in the 6 counties were investigated;the positive rate of RBPT was 2.92%(124/4 253); the positive rate of SAT was 0.85%(36/4 253), while the Coombs was 0.05%(2/4 253), totally infected people was 124, the infection rate was 2.92%(124/4 253); the number of patients was 71, the prevalence rate was 1.67%(71/4 253); and new cases were 68. Conclusions Prevalence of human Brucellosis in Qinghai Province is active in some local areas. We should strengthen health education of occupational population, improve people’s ability of prevention and control, and control prevalence of Human epidemic situation.

Monitoring results of human brucellosis in Qinghai Province in 2011: a field investigation / 中华地方病学杂志

Objective To analyze the epidemic situation of human brucellosis in Qinghai Province,in order to provide a theoretical basis for prevention and treatment of the disease.Methods Xining city,Ping'an,Haiyan,Tianjun,Jiuzhi,Henan and Dari Counties were selected as monitoring counties(city) in Qinghai Province,and three or four townships(towns) were selected as monitoring points in each county.People aged from 6 to 60 closely contacted with livestock were monitored.The methods of rose bengal plate agglutination test(RBPT) and standard tube agglutination test(SAT) were used for serological testing.Results A total of 4 331 people from 6 counties and 1 city were examined for brucellosis,and 225 people (by RBPT) of them were serologically confirmed with a positive rate of 5.19％.SAT positive 63 people,the average positive rate was 1.45％.Two hundred and twenty-five people were infected and the average infection rate was 5.19％.Fifty-six new cases were discovered.Conclusion Human brucellosis has increased in Qinghai Province,effective prevention and cure should be adopted to prevent its outbreak.

Transformation: how do nematode sperm become activated and crawl?

Nematode sperm undergo a drastic physiological change during spermiogenesis (sperm activation). Unlike mammalian flagellated sperm, nematode sperm are amoeboid cells and their motility is driven by the dynamics of a cytoskeleton composed of major sperm protein (MSP) rather than actin found in other crawling cells. This review focuses on sperm from Caenorhabditis elegans and Ascaris suum to address the roles of external and internal factors that trigger sperm activation and power sperm motility. Nematode sperm can be activated in vitro by several factors, including Pronase and ionophores, and in vivo through the TRY-5 and SPE-8 pathways. Moreover, protease and protease inhibitors are crucial regulators of sperm maturation. MSP-based sperm motility involves a coupled process of protrusion and retraction, both of which have been reconstituted in vitro. Sperm motility is mediated by phosphorylation signals, as illustrated by identification of several key components (MPOP, MFPs and MPAK) in Ascaris and the characterization of GSP-3/4 in C. elegans.

The value of serum bile acid in diagnosis of intrahepatic cholestasis of pregnancy / 中国医师进修杂志

ObjectiveTo evaluate the application value of serum bile acid in diagnosing intrahepatic cholestasis of pregnancy (ICP).MethodsThe clinical data of 92 prepartal patients with ICP was analyzed retrospectively.The patients were divided into observation group ( ＞ 40 μ mol/L ) and control group ( ≤40 μ mol/L) with 46 cases each according to serum bile acid level.The nccurrence time of skin pruritus,jaundice degree,serum alanine aminotransferase (ALT),aspartate aminotransferase (AST) and degree of polluted amniotic fluid of two groups were observed and compared.ResultsThe occurrence of skin pruritus in observation group was earlier than that in control group [(29.1 ± 3.4) weeks vs.(33.9 ± 3.2) weeks,P＜0.05 ] ;the cases with severe jaundice,ALT ＞ 100 U/L,AST ＞ 100 U/L and amniotic fluid contamination Ⅲ degree in observation group were more than control group [27 cases vs.15 cases,28 cases vs.20 cases,28 cases vs.18 cases,23 cases vs.15 cases,P＜ 0.01 or ＜ 0.05].ConclusionsSerum bile acid,as a sensitive indicator to assess TCP,has important value in determining the condition of pregnant women and prognosis analysis,and it can reflect the occurrence possibility of bad perinatal outcomes.

Diagnosis and treatment of 21 blunt pancreatic trauma patients / 中华胰腺病杂志

Objective To investigate the diagnosis and treatment of the blunt pancreatic injury.Methods The clinical data of 21 blunt pancreatic trauma patients admitted to our hospital in the past 5 years were analyzed retrospectively.Results 3 of 21 patients were simple blunt pancreatic injury, while the other 18 patients were complicated with other abdominal organs injuries.According to the grading criteria, the number of Ⅰ , Ⅱ, Ⅲ, Ⅳ, Ⅴ grade injury were 4, 7, 5, 3 and 2 cases, respectively, and only 9 patients were diagnosed by CT before operation, and the diagnosis was confirmed during the operation in 11 patients, and 1 was miediagnosed in the first operation.Single drainage or debridement and drainage were performed in 8 cases and distal pancreatectomy with and without spleen were performed in 5 and 3 cases, respectively, and 3patients received pancreaticojejunostomy, 1 received Whipple operation, the other 1 case underwent duodenorrhahy and diverticulation.The mortality rate was 9.5% (2/21), and the complications of pancreatic pseudocyst and fistula developed in 2 (9.5%, 2/21 ) and 5 (23.8%, 5/21 ) cases respectively, and they were cured by drainage, while the other 12 were cured completely.Conclusions The preoperative misdiagnosis rate of pancreatic trauma is high;CT scan should be used to confirm the diagnosis.Careful pancreatic exploration is mandatory and simple and effective surgical procedures with effective drainage is important for treatment success.

Transplantation of allogenic mesenchymal stem cells up-regulates connexin 43 expression in rats with myocardial infarction / 基础医学与临床

Objective To investigate the alterations of connexin 43 (Cx43) expression and its distribution at different stages of myocardial infarction (MI) in rats after transplantation of allogenic mesenchymal stem cells (MSCs).Methods Wistar rats were ligated on the left anterior descending coronary artery to make MI models.They were injected with allogenic MSCs,which were induced by 5-aza and labelled by DAPI,during the second operation after 7 days of MI.In subgroups,MSCs were detected by fluorescence microscope.Cx43 expression and GJ distribu-tion were examined by immunohistochemistry after 4,8 or 12 weeks respectively.Results MSCs differentiated into cardiac muscle cell-like cells which were capable of pulsing spontaneously,expressing cTnT and forming myofilament in vitro.Transplanted MSCs can survive in MI host and upregulate Cx43 expression and normalize Cx43 distribution at ischemic zones after 4,8 and 12w.No change of Cx43 was seen at infarcted zones.Conclusion MSCs have the plasticity of differentiating into cardiac muscle cell-like cells which can continuously upregulate Cx43 expression and normalize Cx43 distribution at ischemic zones after 4,8 and 12w.

mRNA expression of connectin 43 and connectin 45 following transplantation of allogenic bone marrow mesenchymal stem cells in rats with acute myocardial infarction / 中国组织工程研究

BACKGROUND:Cell transplantation can repair damaged myocardial tissue.However,whether transplaned cells and host cells formed an effective electricity and mechanical couple or whether reconstruction of connexin (Cx) and arrhythmia formed,are still unclear.OBJECTIVE:It is hypothesized that arrhythmia can be treated by changing Cx levels and intervening abnormal GJ channel.Moreover,to explore the effects of bone marrow mesenchyma stem cells (MSCs) on the expression of Cx43 and Cx45 in rata with myocardial infarction.DESIGN,TIME AND SETTING:The randomized controlled animal study was performed at the Experimental Center,Guangxi Medical University from January 2008 to May 2009.MATERIALS:A total of 180 Wistar rats were randomly divided into four groups:normal control,sham operation,myocardial infarction,and MSCs,with 45 animals in each group.Each group was then divided into 3 subgroups (n=15) according to 4 weeks,8 weeks and 12 weeks post-transplantation.Additional 20 healthy,Wistar rats,aged 1 month,were selected to harvest MSCs.METHODS:The third passage of MSCs was induced by 5-aza like cardiomyocytes for 4 weeks,labeled with DAPI at 2 hours before transplantation.Models of acute myocardial infarction were established in all groups except sham operation group.At day 7 after model preparation,2×10~(10) /L MSCs were infused into the edge and center of myocardial infarcted region by multipoint injection.Rats in the myocardial infarction group were subjected to an equal volume of saline as wall as those in the normal control and sham operation groups.MAIN OUTCOME MEASURES:The mRNA expressions of Cx43,Cx45 were assayed by fluorescence quantitative PCR.RESULTS:The mRNA expression of Cx43 among each groups had no difference at weeks 4,8 and 12 after intervention in the normal areas.Compared to the normal areas,Cx43 mRNA reduced significantly at ischamic zone in the myocardial infarction group and MSCs group (P＜0.01),with notably increased of Cx45 mRNA expression (P＜0.01).Compared to myocardial infarction group,Cx43 mRNA expression was statistically higher in the MSCs group at the same points (P ＜ 0.01),and the Cx45 mRNA dramatically declined (P ＜ 0.01).CONCLUSION:Acute myocardial infarction reduces the mRNA expression of Cx43 and increases the Cx45 mRNA expression.The exogenous cells transplantation can upturn the mRNA expression of Cx43 in the border-zone of the infarcted area,and down-regulate the Cx45 mRNA expression in the border-zone of the infarcted area.

The action of radial surgery in the treatment of large cerebral metastatic carcinoma / 中国组织工程研究

Objective To investigate the therapeutic effect of radial surgery in large cerebral metastatic carcinoma. Methods Adopt three dimensional oriented radial surgery to 15 patients with the biggest diameter of more than 35mm. Observe the variation of clinical symptoms and analysis the change of CT image. Follow up the survival time, complications and the cause of death at the same time. Results Most of the patients got prominent improvement in symptoms. But the imaging change of carcinoma focus was a slow course comparatively. The survival rate in 1 year was 26％ . Conclusion Radial surgery is an effective, simple and safe method in the treatment of large cerebral metastatic carcinoma. It has a good control rate with only slight complications.

Effects of morphine dependence and withdrawl on SNAPs expression in different brain regions of rats / 中国药理学通报

Aim To investigate the effects of chronic morphine treatment and withdrawal on the level of SNAPs in different brain regions of rats,including nucleus accumbens(NAc),caudate putamen(CPu) and hippocampus(Hip).Methods Adult male Wistar rats were randomly assigned into control,morphine and spontaneous withdrawal group.The morphine dependent rat model was established by subcutaneous morphine injection with increasing doses for 8 d,three times a day(8:00,12:00,and 18:00).The control group was injected with the same volume of normal saline.Rats in morphine group were killed 4 h after the last injection,and rats in withdrawl group were killed at indicated time.Control groups were paralleled with all treatment groups.The brains were removed and the NAc,CPu and Hip were separated.The expression of SNAPs mRNA and protein were determined by RT-PCR and Western blot.Results The expression of ?SNAP in CPu of morphine dependent rats was up-regulated by about 25%(P