Measurement of thrombelastograph index and their correlation with serological indexes in patients with acute cerebral infarction / 心血管康复医学杂志

Objective:To analyze correlation between thrombelastograph (TEG) indexes and serological indexes in patients with acute cerebral infarction (ACI) .Methods :A total of 116 ACI patients treated in our hospital were se‐lected as ACI group ,another 98 cases without ACI , who underwent routine physical examination were regarded as healthy control group .According to severity of neurological function defect during acute phase ,ACI group was fur‐ther divided into mild ACI group (n=51) ,moderate ACI group (n=32) and severe ACI group (n=33) .TEG inde‐xes and serum indexes of platelet activation were measured and compared among above group ,and the correlation a‐mong TEG indexes and serum levels of platelet activation indexes were analyzed .Results:Compared with healthy control group ,there were significant reductions in R value [ (6.17 ± 1.38) min vs .(5.26 ± 0.77) min] and K value [ (2.39 ± 0.53) min vs .(1.71 ± 0.58) min] ,significant rise in α angle [ (63.27 ± 9.23) deg vs .(77.45 ± 12.08) deg] ,MA value [ (55.09 ± 6.38) mm vs .(77.13 ± 13.25) mm] of TEG ;clot index [CI ,(1.68 ± 0.53) vs .(2.56 ± 0.87)] ,D-dimer level [(0.24 ± 0.07) mg/L vs .(0.38 ± 0.09) mg/L] and platelet aggregation rate [PAR ,(56.12 ± 6.75)% vs .(69.17 ± 9.33)% ] in ACI group after treatment ,P<0.05 all .Among ACI subgroups with different severity ,the more severe neurological function defect was ,the lower R and K values were ,the higherαangle ,MA value ,CI ,D-dimer level and PAR were ,there were significant difference in pairwise comparisons ( P<0.05 or <0.01) .Linear regression analysis indicated that PAR was significant inversely correlated with R (B= -2.254) and K values (B= -2.286) ,and significant positively correlated with αangle (B=2.536) ,MA (B=2.537) and CI (B=2.352) ,P<0.05 or <0.01 ;D-dimer level was significant inversely correlated with R (B= -2.276) and K val‐ues (B= -2.259) ,and significant positively correlated with α angle (B=2.621) ,MA (B= 2.462) and CI (B=2.647) , P<0.05 or <0.01. Conclusion:TEG indexes are significantly correlated with platelet activity in ACI pa‐tients .TEG possesses good practical value in diagnosis ,severity judgment and therapeutic guidance for these pa‐tients .

Manufacture and comparison of chronic rejection model of orthotopic and heterotopic intestinal ;transplantation in rats / 器官移植

Objective To compare the modeling effect of chronic rejection following orthotopic and heterotopic intestinal transplantation in rats.Methods F344 (RT1 1 vr )rats were used as the donors and Lewis (RT1 1 )rats were used as the recipients.Models of allogeneic heterotopic and orthotopic intestinal transplantation in rats (8 rats in each model) were established,and subcutaneous injection of ciclosporin was given at 0 ~1 4 d after operation.Changes in body weight and survival time of the recipients were observed after operation.In addition,pathological changes in intestinal tissue were observed by hematoxylin-eosin (HE)staining.Changes in collagenous fibers and elastic fibers in intestinal tissue were observed after alcohol and hematoxylin staining.Finally,success rate of modeling of recipients in two groups was calculated.Results Rats in heterotopic and orthotopic intestinal transplantation groups were able to survive for a long time,most of which were more than 90 d.For the rats in orthotopic intestinal transplantation group,normal diet could be recovered at the 3 rd d after operation.Their body weight could recover preoperative level at about the 1 4th d after operation,and then grew slowly.However,most of the rats in orthotopic intestinal transplantation group continued weight loss from the 1 50th d after operation,which could not be reversed with ciclosporin.For the rats in heterotopic intestinal transplantation group,normal diet could be recovered at the 1 st d after operation,and their body weight could recover preoperative level within 25-30 d after operation and gradually rose and remained at a high level within 30-90 d after operation.No pathological changes of chronic rejection and obvious mesangial fibrosis in intestinal tissue were observed at the 90th d after operation,but intestinal tissue developed chronic rejection and obvious mesangial fibrosis at the 1 63 rd d and 200th d after operation in orthotopic intestinal transplantation group.Typical pathological changes of chronic rejection and mesangial fibrosis in intestinal tissue were observed at the 90th d and 200th d after operation for rats in heterotopic intestinal transplantation group.All the rats in heterotopic intestinal transplantation group showed characteristic pathological changes.The success rate of modeling was 1 00% in heterotopic intestinal transplantation group,which was not of statistical significance,compared with the success rate of modeling of 75% in the orthotopic intestinal transplantation group (P >0.05).Conclusions Chronic rejection will occur at different time points with small dose of ciclosporin after operation if models of orthotopic and heterotopic intestinal transplantation are established in combination of F344 → Lewis rats.Compared with orthotopic intestinal transplantation,the rat model of heterotopic intestinal transplantation holds the advantages of simple modeling,shorter chronic rejection and relatively consistent degree of pathological changes,which is more suitable for experimental study.

Location of bone marrow mesenchymal stem cells in rats after small intestinal transplantation / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the bone marrow mesenchymal stem cells (MSC) settled in rats after small intestinal transplantation.</p><p><b>METHODS</b>Bone marrow MSCs were taken from 1-month male Lewis rats, isolated and cultured by density gradient centrifugation and differential adherent culture. The surface antigens (CD29, CD90, CD34 and CD45) of MSC were identified by flow cytometry. Final concentration of 5 μg/L CFSE was used to mark the third generation of MSCs. Adult male inbred line F344 rats were used as donor and adult male Lewis rats as acceptor. A heterotopic intestinal transplant rat model was established by F344 to Lewis. Labeled MSCs were injected into model rats through vena dorsalis penis after operation. Tissues at postoperative 7-day were collected for frozen pathology to reveal the location of transplanted MSCs under fluorescence microscope.</p><p><b>RESULTS</b>MSCs were successfully isolated from rat bone marrow. The average positive expression rates of surface antigens CD29, CD90, CD34 and CD45 were 96.48%, 99.77%, 2.41% and 1.39% respectively. MSCs were successfully and effectively marked with CFSE. Seven days after operation, a large number of green fluorescence could be observed in transplanted intestine, spleen and thymus. Autograft intestinal tissues only showed trace fluorescence, and the heart, liver and lung tissue basically did not present the green fluorescence.</p><p><b>CONCLUSION</b>Bone marrow MSCs can settle in transplanted small intestine of rat.</p>

Research on the suppressive effect on transplantation rejection by indoleamine 2, 3-dioxygenase / 中华外科杂志

<p><b>OBJECTIVE</b>To study the suppressive effect of indoleamine 2, 3-dioxygenase on transplantation rejection in mice heterotopic cardiac transplantation.</p><p><b>METHODS</b>Adenovirus vector containing IDO gene was used to infect donor (C57BL/6) DC to obtain IDO(+)DC. Mouse heterotopic cardiac transplantation models were established (C57BL/6-BALB/c) and the following groups were set up, including the control group, DC injection group, TC injection group, IDO(+)DC injection group and co-injection group of IDO(+)DC and TC, 12 donors and 12 recipients in each group.Survival time of the donor heart in every group was observed. Meanwhile, donor hearts were harvested 7 days post transplantation for different examinations, including pathological examination, mRNA expression of IDO through real-time PCR, IDO protein expression through Western blot. Peripheral blood of recipients was also harvested for CD3(+)T lymphocyte apoptosis rate examination through fluorescence-activated cell sorting.One-way ANOVA and Kaplan-Meier Survival Analysis were used for statistic analysis of IDO expression, CD3(+)T lymphocyte apoptosis rate and survival time of the donor heart respectively.</p><p><b>RESULTS</b>Cadiac allograft median survival time of each group were 7.0, 7.5, 11.0, 17.5, 24.0 days respectively. Compared with control and DC injection group, IDO(+)DC, TC and co-injection group significantly prolonged the survival time of donor hearts (t = 3.523-8.449, P < 0.01). Both IDO mRNA and protein expression showed significant increase(t = 5.974-16.176, P < 0.01). The CD3(+)T lymphocyte apoptosis rate was also significantly increased (t = 6.324-38.120, P < 0.01). Compared with IDO(+)DC or TC group alone, co-injection group significantly prolonged the survival time of the donor heart (t = 5.971 and 2.831, P < 0.05). Both IDO mRNA and protein expression showed significant increase (t = 2.853-15.194, P < 0.01).Furthermore, the CD3(+)T lymphocyte apoptosis rate was significantly increased as well (t = 26.069 and 7.643, P < 0.05).</p><p><b>CONCLUSIONS</b>Suppressive effect of co-injection of IDO(+)DC and TC is much more effective than administration of IDO(+)DC or TC alone, which suggests that IDO achieved immune suppressive effect through the pathway of tryptophan depletion and accumulation of TC.</p>

Inhibitory effect of high expression of IDO from donor DCs on allograft rejection in mice heterotopic cardiac transplantation model / 中华器官移植杂志

Objective To investigate the effect of high expression of functional IDO trom donor DCs on transplantation rejection in mice heterotopic cardiac transplantation.Method Adenovirus vector containing IDO gene was used to infect donor (C57BL/6) DCs to obtain IDO+ DCs.Mouse heterotopic cardiac transplantation models were established (C57BL/6-BALB/c) and the following groups were set up:control group,DCs injection group and IDO+ DCs injection group.Survival time of the donor heart in all groups was observed.Meanwhile,donor hearts were harvested at 7 th day post-transplantation for different examinations,including pathological examination,mRNA expression of IDO by real-time PCR,and IDO protein expression by Western blotting.Peripheral blood of recipients was also harvested for T lymphocyte apoptosis rate examination by FACS.Result Cardiac allograft median survival time in control group,DCs injection group and IDO+ DCs injection group was 7,7.5,and 17.5 days respectively.IDO+ DCs treatment significantly prolonged the survival time of donor hearts (P＜0.01).Pathological grading was significantly decreased (P＜0.01).The CD3+ T lymphocyte apoptosis rate in peripheral blood of recipients in IDO+ DCs injection group was (46.50 + 5.02)％,significantly higher than the other two groups (P＜0.01).Both IDO mRNA and protein expression showed significant increase (P＜0.01).Conclusion The preoperative medication with IDO+ DCs injection to the recipients could induce T lymphocyte apoptosis and significantly suppress the rejection in mice heterotopic cardiac homotransplantation.

Experimental study of platelet derived growth factor expression in small bowel transplantation of rats / 中国综合临床

Objective To investigate the expression of platelet derived growth factor(PDGF) in small bowel transplantation of rats.Methods Isogeneic and allogeneic small bowel transplantation were performed in rats by microsurgical technology.All rats were divided into two groups:isogeneic control group and allogeneic test group.Transplanted tissues were test on 7th,28th and 90th after surgery.Positioning using immunohistochemical method the expression of PDGF.Real time PCR and immunohistochemical staining were also performed to detect the expression of PDGF.Results The unique feature including intestinal graft fibrosis was showed in tissues.Immunohistochemistry results showed PDGF expression was higher in intestinal glands.PDGF mRNA levels in transplanted tissues showed a gradual upward trend,and the top levels is in POD90.Conclusion PDGF expression was significantly higher in the late of intestinal transplantation,which showed an guideline for chronic rejection of intestinal transplantation.

The differential requirement of mushroom body α/β subdivisions in long-term memory retrieval in Drosophila

The mushroom body (MB), a bilateral brain structure possessing about 2000-2500 neurons per hemisphere, plays a central role in olfactory learning and memory in Drosophila melanogaster. Extensive studies have demonstrated that three major types of MB neurons (α/β, α'/β' and Γ) exhibit distinct functions in memory processing, including the critical role of approximately 1000 MB α/β neurons in retrieving long-term memory. Inspired by recent findings that MB α/β neurons can be further divided into three subdivisions (surface, posterior and core) and wherein the α/β core neurons play an permissive role in long-term memory consolidation, we examined the functional differences of all the three morphological subdivisions of MB α/β by temporally precise manipulation of their synaptic outputs during long-term memory retrieval. We found the normal neurotransmission from a combination of MB α/β surface and posterior neurons is necessary for retrieving both aversive and appetitive long-term memory, whereas output from MB α/β posterior or core subdivision alone is dispensable. These results imply a specific requirement of about 500 MB α/β neurons in supporting long-term memory retrieval and a further functional partitioning for memory processing within the MB α/β region.

Surgical treatment for the pancreatic benign tumor following organ preserve principle / 中华肝胆外科杂志

Objective To summery the value of treatment for pancreatic benign tumor following the organ preserve principle.Methods The clinical data of 77 patients with pancreatic benign tumor at the General Hospital of Tianjin Medical University from Jan 2002 to Jan 2012 was analyzed.All patients were divided into traditional pancreatic surgical treatment group (n=24) which include pancreaticduodenectomy(PD) and pancreatic body and tail resection plus spleenectomy(DP) and treatment following organ preserve principle (n =53).Results There are tumor evacuation,segmentectomy,pancreatic head resection with duodenum preserving and pancreatic body and tail resection with spleen preserving in the group of treatment following organ preserve principle.Pathology diagnosis showed insulinoma 30 cases,mucinous cystadenoma 16,serous cystadenoma 10,intraductal papillary mucinous tumor 17,solid pseudopseudopapillary tumor 3 and 1 case of pancreatic intraductal hyperplasia.The rate of pancreatic leakage were 26.3％ (5/19) in traditional surgical treatment group and 24.3％ (9/37) in group of treatment following organ preserving respectively.There was no significant difference between these two groups(P＞0.05).The rate of new development diabetis and aggrasive of the preexist diabetis post the pancreatic surgery were 20.8 ％ (5/24),20 ％ (1/5),13.2(7/53),30 ％ (3/10)respectively.There was no significant difference between these two groups(P=0.485,P=1.000).Conclusions The surgical treatment following the organ preserving is a safe and effective procedure for the patients with pancreatic benign tumor.This new method can preserve the pancreatic parenchymal maximally,avoid the extra-and endo-secrete function loss and preserving the function of spleen.

Primary hyperparathyroldism in the mainland of China / 中华普通外科杂志

Objective In China primary hyperparathyroidism is not a kind of common disease as in the wesyrn countries.This article reports the current status in the diagnosis and treatment of primary hyperparathyroidism in the mainland of China. Methods We collected 730 cages of primary hyperparathyroidism diagnosed and treated in 7 top hospitals for endocrine surgery from 1965 to 2005.Results In this study.652(89.3%)cases were clinically symptomatic while 78(10.7%)cases were asymptomatic:442 cases were positive on 99mTc-MIBI scanning.Bilateral explorations were undertaken in 377 patients and unilateral or uni-gland exploration through the conventional incision in 204 cases.Minimally invasive parathyroidectomy in 143 cases.Endoscopically assisted 2 cm incision was taken in 6 cases for unilateral gland exploration.Pathologically 632(86.6%)cases were identified as adenoma,58(8.3%)cases were of hyperplasia and 40(5.5%)cases were of carcinoma.There were no major postoperative complications.While 20 patients suffering from recurrence or persistent postoperative hyperparathyroidism,the others are of normal or depressed serum level of calcium. Conclusions Preoperative localization is very helpful: Unilateral exploration for parathyroid adenoma is feasible; minimally invasive parathyroidectomy throush minimal incision is a kind of improving procedure for the localized parathyroid adenoma.

Small bowel transplantation and chronic rejection / 国际外科学杂志

Recently,there was great development in the field of small bowel transplantation,which has been become effective in clinical research.However,similarly with the transplantations of heart,lung,liver and kidney,chronic rejection was becoming an important factor for the long-term survivals of grafts.With the deepening comprehensions towards the mechanism of chronic rejection,more methods and therapies were tried and tested.

An experimental study on immune protection of liver graft for simultaneous small bowel transplantation / 中国普通外科杂志

Objective To study the immune protective effects of liver graft on intestinal graft in simultaneous liver/small bowel transplantation. Method Rat models(Wistar to SD) of liver/small bowel transplantation(LSBTx),single liver transplantation(LTx)and single small bowel transplantation(SBTx) were established respectively. Twelve recipients from each group were used to determine survival time. Six recipients from each group were sacrificed for liver and/or small bowel biopsy at posttransplantation day 5,7 and 14,respectively. Rejections were detected by histopathology and mRNA expression of IL-2,IL-4,perforin and granzyme B in grafts by semi-quantitative reverse transcript PCR. Result The survival time of LSBTx recipients was (27.83?4.47) d,much longer than SBTx recipients (11.58?3.26) d,but was similar to LTx recipients (28.92?2.39) d. Allograft rejections of intestinal graft in LSBTx group were milder than that in STBx group,accompanied by down-regulated mRNA expression of perforin and granzyme B. Conclusion Simultaneous liver/small bowel transplantation in rats provides immune protection on intestinal graft.

Changes of free amino acids in gastric cancer tissue and it's relationship with cancer stages / 肠外与肠内营养

Objectives:To determine the content of aminoacids in gastric cancer tissue and study the relationship between alterations of amino acids and cancer stages.　Methods:19 free amino acids of cancer tissue and paracancerous normal mucose were determined in 41 cases of gastric cancer.　Results:Most free amino acids were significantly increased in gastric cancer tissue as compared with those of paracancerous normal gastric tissue.The contents of proline,valine,methionine,isoleucine,leucine in advanced gastric cancer were significantly higher than those in early cases.　Conclusions:Gastric tumor tissue contains high amount of most free amino acids particularly in cases with advanced cancer..

Expression of Cyclie E in colorectal carcinoma and its significance / 中国现代普通外科进展

Objective: To investigate the expression of Cyclin E in colorectal carcinoma and its significance.Methods: The Cyclin E expression and the cell proliferation(PI,SPF)in 30 cases of colorectal carcinomas (including tumors and normal tissues distant to the tumors)were respectively assayed with Flow Cytometry (FCM), and the relationships between the Cyclin E expressive rate and clinical pathologic features were compared. Correlaction between the Cyclin E expressive rate and the cell proliferation(PI, SPF) was analyzed too.Results: The Cyclin E positive rate and the cell proliferation in colorectal carcinoma were significantly higher than those of the distal normal tissues. As for the Cyclin E positive rate and the cell proliferation,no significant differences were found among the subgroups divided according to malignance, lymphatic metastasis and the site of tumor. There was a significant correlation between the Cyclin E positive rate and the cell proliferation.Conclusion: The Cyclin E overexpression plays an important role in the onset of colorectal carcinoma.The Cyclin E expressive rate is not consistent with the general clinical pathologic features,but with the cell proliferation. The Cyclin E expressive rate may be one of the potential prognostic indicators in coloretal carcinoma.

Value of preoperative imaging localization for primary hyperparathyroidism / 中国普通外科杂志

Objective To evaluate US, CT and 99mTc-MIBI in the localization of hyperfunctioning parathyroid tumors. Methods Among the 47 patients with primary hyperparathyroidism 45 underwent ultrasound, 47 did CT scan and 36 did double phase imagings. Results Forty-six adenomas, 2 adenocarcinomas and 2 hyperplastic glands were removed from 47 patients. The results showed that the sensitivities were 43%,78%,92% for B-utrasound; CT and isotope imaing respectively.The specificities were 96%,97%,100%;and the accuracies were 82%,92%,98%. There was significant difference between 99mTc- MIBI and CT (? 2=6.627,? 2=4.884,P

Endogenous telomerase catalytic inhibitor PinX1 and its relationship with expression of hTERT and hTRF1 in human colorectal cancer / 中国普通外科杂志

Objective To study the role of endogenous telomerase catalytic inhibitor PinX1 in the progression of colorectal cancer tissue. Methods The expression of PinX1、telomerase subunits(hTERT) and telomere binding protein(hTRF1) was detected by semi-quantitative RT-PCR. Surgically resected colorectal cancer specimens in 66 cases were studied. Results PinX1 expression is significantly correlated with histologic differentiation,clinical stage and lymph node metastasis of colorectal cancer( Fd =11.40, Fs = 4.22,t =-2.81,P ≤0.05). The level of PinX1 was negatively associated with the expression of hTERT( r =-0.553,P