[Objective]To investigate the repairing effect and mechanism for treatment of femoral head necrosis on transplantation of bone marrow stromal cells.[Method]Twenty-four Newzland rabbits were divided into two groups randomly,Group A as core decompression group and Group B as Bone marrow stromal cells autograft group.Animal femoral head neorosis model was made by freezing method with liquid nitrogen.After freezing and drilling,The drilled necrotic cavities of Group A was implanted with gelatin sponge,while of Group B was with gelatin sponge combined by bone marrow stromal cells.Three animals in every group were sacrificed respectively at 2,4,6,8 weeks and subjected to radiograph and microscope examination.[Result](1)Radiograph examination:At 2 weeks,the drilled holes in Group A and B all presented low density images.At 4 weeks,the density in the drilled holes increased in group B and the density around the drilled holes increased in group A.At 8 weeks,sclerotic line formed around the drilled holes in Group A and trabeculae appeared in the drilled holes in group B.(2)Microscope examination:in group A,at 2 weeks,a few inflamatory cells appeared in the holes with many osteoblasts and ostoid appeared around the drilled holes.At 8 weeks,marrow formed in the drilled holes in group B,at 2 weeks,there were a large amount of osteoblasts in the drilled holes and some ostoid formed around thc drilled holes.At 4 weeks,the drilled holes were full of trabeculae.At 8 weeks,the trabeculae matured with the marrow appeared in the intertrabecular space.[Conclusion]Bone marrow stromal cells autografting may be an effective way to treat rabbit femoral head necrosis.

Objective To study the effect of tumor necrosis factor(TNF) and endothelin(ET) on the formation of murine hyperdynamic circulatory syndrome(HCS).Methods Circulation stable HCS model was produced in rats by partial portal vein ligation.Portal blood TNF and ET was determined pre and post injection of anti rat TNF and hemodynamics was monitored simultaneously.Results TNF level did not change 0 5 hour after partial portal vein ligation,but it increased significantly at 24 hour and maintained at this high level thereafter. ET was on a small increment at different time after partial portal vein ligation.The TNF level decreased significantly to the level in controls and ET remained unchanged after injection of anti rat TNF,while HCS was partially ameliorated. Conclusion [WT5”BZ] TNF may be related with the start and maintenance of HCS,and there is no causality between ET and the development of HCS.

Problem-based learning(PBL) is a method of the self-study primarily and teacher' s guiding.By using the PBL in the clinical teaching application,we discuss our experience gained in carrying,out PBL and the existing problems.

Objective To dectect the expression of CD54 in thyroid tissue of Hashimotos thyroiditis patients,and expression changes of CD54 on thyroid cells interferred by different agents.Methods The thyroid tissues from 41 cases of Hashimotos thyroiditis were collected and 26 normal thyroid tissues served as normal controls.All thyroid tissues were identified by pathological examination.The positive expression rate and area of CD54 were investigated by immunohistochemical method and quantitative analysis of image analysis system in all thyroid tissues.The expression changes of CD54 in the isolated thyroid cells interferred by 100,500,1 000 pg/ml IL-1? or 10 mg/L NaI or 1 000 pg/ml IL-1? and 10 mg/L NaI for 48 h were detected by flow cytometry.Results The positive expression rate of CD54 in Hashimotos thyroiditis tissues was much more than that of control tissues(P

Objective To investigate the influences of anesthetic meltod on setting up the animal model of orthotopic liver transplantation(OLT) in rats, in order to properly select the anesthetic method. Methods OLT was performed by modified two-cuff technique in Sprague Dawley rats. 100 rats were randomly divided into 5 groups: control group, ether group, ketamine group, chloral hydrate group and pentobarbital group. The anesthetic process, the influences of anesthetic method on physiologic parameters and hepatic function, and the mortality during anhepatic phase of each group were observed. Results The anesthetic process of each anesthetic method was different,ether anesthesia had fewer impacts on physiologic parameters, and the pentobarbital had great hepatotoxicity. High mortality happened in ketamine group, chloral hydrate group and pentobarbital group during anhepatic phase, while no animal died in ether group. Conclusions Each anesthetic method has significant influences on the OLT rat. Ether anesthesia has fewer effects on physiologic parameters and liver function, and has low mortality during anhepatic phase of OLT rats.So it is the best anesthetic method in setting up the animal model of OLT in rats.

Objective To study the therapeutic effect of continuous renal replacement therapy (CRRT) in renal failure after liver transplantation.Methods Renal function in 82 patients who underwent CRRT in the perioperative period of liver transplantation were retrospectively analyzed.Results There were significant differences in ALT,TB,BUN and Cr before and after the treatment (P ＜ 0.05).The differences were significant in glutamic-pyruvic transaminase (ALT),creatinine phosphate kinase (CPK) and C reactive protein (CPR) before and after the treatment (P ＜0.05).There were significant improvements in K+,Na+,Cl-,HCO3-and CVP before and after the treatment (P ＜ 0.05),while the differences were not significant in other biochemical parameters (P ＞ 0.05).This research also looked at the effect of timing of CRRT on renal function recovery.Based on the RIFLE classification of AKI,the ratio of renal function recovery in RIFLE-Ⅰ was significantly higher than RIFLE-F (P ＜ 0.05).Conclusion CRRT treatment significantly improved the prognosis of patients with acute renal failure after liver transplantation.

Object Through performing the service satisfaction survey,to learn their interest claim and discover the service defects ,so as to provide advice and countermeasures.Method Using field survey methods and statistics analysis to study.Result The satisfaction of relatives of pediatric patients at the level of "relatively good" and "good" is about 60% both in medical treatment environment and equipment ,over 70% in medical treatment effect,doctor capacity,nursing capacity and overall assessment,but only 5.1% in medical expenses.Conclusion Relatives of pediatric patients have high satisfaction in treatment capability of medical staff,medical treatment effect as well as overall assessment ,normal satisfaction in medical environment and equipment,but lowest satisfaction in medical expenses,and the satisfaction in tertiary hospital is not high.Relatives in some districts demand much in some aspects,such as improving hospital environment,attaching importance to ward hygiene ,improving service attitude,and providing single ward ect.

Objective To evaluate the effect of pediatric renal transplantation using donation after cardiac death (DCD).Methods The male DCD meeting Chinese standard Ⅲ (C-Ⅲ) was 49 years old,and the recipient with chronic renal failure was 14 years old.The right kidney of the donor was transplanted to the recipient.The renal artery and renal vein of the donor were end-to-side anastomoscd to the common iliac artery and common iliac vein of the recipient,respectively.The graft was transplanted into the fight iliac fosse.Warm ischemia time was 12 min,and cold ischemia time was 2 h.Immunity induction therapy was performed with basiliximab.Tacrolimus + mycophnolate mofetil + Pred were used as immunosuppressive regimen.Results The transplantation was done successfully.One day after operation,ALT was increased dramatically.The recipient was diagnosed as acute drug-induced liver injury.There was no occurrence of acute rejection and delayed graft function.The recipient was discharged one month after the operation,and followed up for 6 months with normal graft function.Conclusion Pediatric renal transplantation using DCD is effective and safe,even though the long-term effect still needs to be further observed.

Objective To establish a mouse model of aorta dissection (AD) by β-aminopropionitrile (BAPN) in drinking water + subcutaneously pumped angiotensin II (Ang II) infusion.Methods Forty 3-week-old C57B1/6J male mice were randomly divided into two groups.All animals received 0.1 g/kg/d BAPN in drinking water for 4 weeks.Then the BAPN drinking + saline infusion group and BAPN drinking + Ang II infusion group received continuous saline or Ang II (1,000 ng/kg/min) infusion, respectively, via subcutaneous osmotic minipump for 72 hour.The mice were restricted in a noninvasive computerized tail-cuff system and their arterial systolic blood pressure and heart rate were monitored.Autopsy was performed if a mouse died during the experiment.At the end of the experiment, mice were sacrificed by injection with an overdose of sodium pentobarbital and the aortas were harvested.The formation of aortic false lumen was observed by pathology using hematoxylin-eosin staining.Results The overall incidence of AD in the BAPN drinking administration +Ang II infusion group was 95%, whereas the incidence of AD in the BAPN drinking administration +saline infusion group was only 5%.The mortality from dissecting aneurysm rupture was 24% in the BAPN drinking administration +Ang II infusion group during the experiment.Pathological examination of the aortic cross-sections clearly showed the formation of blood-filled false lumens induced by Ang II.Conclusions A mouse model with high incidence of aortic dissection is successfully established.

Objective To study the relationship between the CT value and injury of ultrastructure in posttraumatic acute diffuse brain swelling(PADBS). Methods The change of CT value of brain tissue was analyzed at posttrauma and preoperation in 9 patients, in combination with the ultrastructure in brain parenchyma in 36 specimen taken from operations. The relationship between the descend of CT value and ultrastructure injury was analysed.Results The CT value of brain in preoperation was lower than it in posttrauma first scanning(2.5～4.3 HU).The capillary distention and stenosis and the diffuse edema in pericapillary and intercellular were observed under transmission electron microscopy(TEM). The nucleolus of neuronal cells displaced to membrane or disappeard. Chromation agglutionation, nuclear membrane circuity, perinuclear diffuse lipid drops and blankspace were detected. The mitochondrion swelling, mitochondrial crest blurring or effacement, rough endoplasmic reticulum distension and its’ granules detachmen were also seen under TEM. Axolemma edema, microfilaments and microtubules derangement in axis-cylinder were found too. The similar phenomena existed in astrocyte.Conclusion The descent of CT value in PADBS was relevant to the aggravation of vasogenic cerebral edema, cytotoxic cerebral edema and ultrastructure injury in brain parenchyma.