BACKGROUND:The repair effects of bone marrow mesenchymal stem celltransplantation on brain injury were not ideal. Combined therapy with medicine and biological engineering materials is needed. OBJECTIVE:To investigate the effects of bone marrow mesenchymal stem celltransplantation and fingolimod immunosuppressants on memory function recovery in rats with brain injury. METHODS:A total of 60 healthy Sprague-Dawley rats were subjected to hydraulic shock with peak value of 253.312 5-303.975 kPa with a hydraulic head injury instrument so as to induce a model of severe hydraulic head injury. They were randomly divided into brain injury group, bone marrow mesenchymal stem celltransplantation group and fingolimod+bone marrow mesenchymal stem celltransplantation group. The Morris water maze test was tested at 21-28 days after PKH-26-labeled bone marrow mesenchymal stem celltransplantation. The PKH-26 immunofluorescence and hematoxylin-eosin staining were conducted in brain tissues at 4 weeks after brain injury. RESULTS AND CONCLUSION:At 4 weeks after transplantation, the average escape latency was gradual y decreased in each group. The average escape latency was shorter in the fingolimod+bone marrow mesenchymal stem celltransplantation group than in the bone marrow mesenchymal stem celltransplantation group (P<0.05), and significantly shorter than in the brain injury group (P<0.01). The number of times of crossing the platform and the percentage of swimming distance to total distance were higher in the fingolimod+bone marrow mesenchymal stem celltransplantation group than in the brain injury group and bone marrow mesenchymal stem celltransplantation group (P<0.05). The number of PKH-26-positive cells was significantly higher in the fingolimod+bone marrow mesenchymal stem celltransplantation group than in the brain injury group and bone marrow mesenchymal stem celltransplantation group (P<0.05). Results confirmed that bone marrow mesenchymal stem celltransplantation could apparently improve memory function of rats with severe brain injury. The combined application of fingolimod immunosuppressants has synergistic effects.

Objective To explore the related high risk factors of hyponatremia after transsphenoidal approach for pituitary adenomectomy and to direct postoperative nursing. Methods The clinical data of seventy-seven patients suffering from pituitary adenomas with the way of treatment by transsphenoidal pituitary adenomectomy from June 2014 to May 2015 were summarized retrospectively. According to the value of postoperative serum natremia, the data were divided into hyponatremia group and non-hyponatremia group. The different data between the 2 groups were compared and the high risk factors related to hyponatremia were analyzed. Results Univariate analysis showed that gender(P=0.254) and high blood pressure(P=0.742) were unrelated to postoperative hyponatremia and there was significant difference between two groups in age (P=0.038), max- diameter of tumors(P=0.004), preoperative pituitary dysfunction (P=0.013), visual deficit (P=0.000), operative procedure duration (P=0.008) and diabetes mellitus rate (P=0.023). While Logistic regression analysis showed that preoperative visual deficit (OR=0.152,P=0.004,95%CI 0.043-0.542) and preoperative pituitary dysfunction (OR=0.069, P=0.046,95%CI 0.005-0.950) were independent factors for postoperative hyponatremia. Conclusions Hyponatremia is a common complication after transsphenoidal pituitary adenomectomy. The optimal treatment can benefit the early recovery and more careful nursing should be focused on these patients who are in high risk of postoperative hyponatremia.

Extracellular vesicles (EV) miRNAs are a class of small non-coding RNAs that are encapsulated in membrane-containing vesicles from a variety of cells, and which can mediate intercellular communication and transfer of functional molecules. EV miRNAs in circulation can be served as novel molecular markers for cancer diagnosis, monitoring and prognosis, and also the most promising liquid biomarkers for clinical translation and utility currently, while optimal research strategy is crucial for identifying valuable EV miRNAs in clinical study. Moreover, EV miRNAs have recently also been implicated in cancer progression as direct regulators of metabolic reprogramming, mesenchymal-to-epithelial transition, angiogenesis, anti-cancer immune response and drug resistance in the tumor microenvironment. Study on some key EV miRNAs involving in those processes may highlight their potential utility as liquid biopsies in early diagnosis, companion diagnosis, metastasis, therapeutic control, prognosis analysis as their therapeutic potential for patients with cancer.

Objective To develop a Chinese version questionnaire of psychosocial adaptation for breast cancer patients with good reliability and validity.Methods The preliminary questionnaire was formed by extensive literature review,semi-structured interview for 10 breast cancer patients and consultation for 4 experts.In order to analyze items and test reliability and validity,228 postoperative breast cancer patients were selected.Results Psychosocial adaptation questionnaire included 44 items and 5 dimensions.It had good content validity and construct validity.With the method of principle components analysis,and five factors were extracted,the cumulative contribution rate was 54.578％,loading for most factors was over 0.4.The result indicated that the structure of the questionnaire was similar to the theory construction.The criterion-related validity with self-rating anxiety scale,the general self-efficacy scale,and self-acceptance questionnaire was-0.757、0.505、0.691.Cronbach's α coefficient of the overall questionnaire was 0.945,retest correlation coefficient was 0.961.Conclusions The developed questionnaire showed good reliability and validity.It can objectively and effectively evaluate psychosocial adaptation of breast cancer patients,so it has practicality and popularization value.

Biliary stricture after cholecystectomy poses difficult management problems to surgeons because of high and stable incidence.In contrast to malignant stricture,benign stricture requires durable repair.Repeated operations may not only increase the suffering of the patient,but also reduce the likelihood of a better outcome. A 56-year-old woman with biliary stricture after cholecystectomy who had undergone several operations in other hospitals was admitted to Chinese PLA General Hospital.Computed tomography (CT) scan showed a dilated biliary tree and localized the level of ductal obstruction in the hepatic hilar stricture.In addition,CT identified fluid collections in the left upper quadrant and no artery injury was detected. Ultrasound-guided percutaneous abdominal drainage was performed to control the abdominal infection. Magnetic resonance cholangiopancreatography classified the injury as Bismuth Ⅲ.The patient with bile leakage and severe abdominal infection was treated with antibiotics before the final operation.On June 1,2012,the patient received Roux-en-Y hepaticojejunostomy.After operation,the patient recovered smoothly without severe complications,such as bile leakage,cholangitis and recurrent stricture.Liver function of the patient was back to normal and T tube drainage was pulled out at the end of 3 months of follow up.

Objective To evaluate the effect of esmolol on refractory veatricular fibrillation just after aortic declamp during cardiopulmonary bypass.Methods 40 patients undergoing valve replacement occurring refractory ventricular fibrillation after release of aortic cross-clamp was randomly given esmolol (prepared to 10 mg/ml) 1 mg/kg(group esmolol,n =20),or Lidocaine (prepared to 10 mg/ml) 1 mg/kg(group control,n=20),the endocardial electric defibrillation was continued after 2min.If the fibrillation still can not be reversed after another two times defribrillation,the routine clinical method would beused.The time of aortic cross-clamp,rectal temperature,MAP,and the value of serum Lactic acid,potassium,and PH were recorded.After intervention,the times of defibrillation,heart rate and rhythm 5 min after reversal were recorded.At the end of CPB,the CPB time and the dosage of positive inotropic drugs were also recorded.Results The success rate of defibrillation was higer in group esmolol than control group(P ＜0.05).Heart rate after reversal in group esmolol were slower than that in control group(P ＜ 0.05).The CPB time of control group was longer than group esmolol (P ＜ 0.05),and the dosage of positiveinotropic drugs was significantly higher in control group(P ＜ 0.01).Conclusion When occurring refractory ventricular fibrillation just after aortic declamp during CPB,Using esomolol by way of intravenous infusion can apparently reduce the frequency of defibrillation,and improve the rate of rewersal.It can also be favorable to cardiac function,and decrease the dependency of positive inotropic drugs,and shorten the time of CPB.

Objective To investigate the risk factors of contrast-induced nephropathy (CIN) in patients after coronary angiography.Methods Two hundred patients underwent coronary angiography were enrolled in this study.The patients were divided into CIN group and non-CIN group according to the occurrence of CIN after coronary angiography of 48-72 h,and then the related risk factors of CIN were analyzed.Results Thirteen cases of CIN were found in 200 patients,and the occurrence rate was 6.5％(13/200).Logistic regression analysis showed that risk factors of CIN included primary renal insufficiency,diabetes,contrast agent dose and advanced age (P ＜ 0.05).Conclusion Primary renal insufficiency,diabetes,contrast agent dose and advanced age are risk factors of CIN in patients after coronary angiography.

Objective To investigate the epidemiological characteristics of hemoglobin variability (Hb-Var) in dialysis patients,and to explore the factors related to Hb-Var and the relationship between Hb-Var and patients outcomes.Methods The study enrolled 178 hemodialysis and peritoneal dialysis patients in the Department of Nephrology,Peking University People's Hospital between October 2009 and March 2010.First six months were observation period,and then followed up for 12 months.The Hb-Var was described by residual standard deviation (Res-SD) and fluctuation across threshold of the Hb level.Non-fatal cardiovascular events and mortality were the primary endpoints.Results The Res-SD was (4.74±2.66) g/L in dialysis patients.Most patients fell into groups of high amplitude (HA) and low amplitude low (LAL),with frequency of 29.8％ and 33.1％ respectively.The related factors of Hb-Var were fluctuation of erythropoietin (EPO) dosage and hemodialysis.Kaplan-Meier survival curve and multivariable adjusted Cox regression indicated that Res-SD had no impact on the primary endpoints.Accumulative time to reach target hemoglobin level was an independent factor related to outcome.Conclusion Hb-Var occurs commonly in dialysis patients.The fluctuation of EPO dosage and dialysis style increase Hb-Var.Accumulative time to reach target hemoglobin level is an independent factor related to patients outcomes.

Objective To explore the effect of different antifreeze or antioxidant at different cryopreservation conditions on the activity and the morphology of adipose cells.Methods After purification,fat granules were divided into 5 groups; the same volume of antifreeze or antioxidants were added in each group,stored at-20℃ (refrigerator),-80℃ (ultra-low-temperature refrigerator) and-196 ℃ (liquid nitrogen) ; the amount of glucose transfer was determined and the morphological changes were observed for each group after two weeks,two months,and three months.Results Fat activity of the group adding both dimethyl sulfoxide (DMSO) and trehalose was significantly higher than that in other groups at the same temperature and the same time point.The decreased amount of glucose transfer of 80℃ group and 196℃ group was significantly lower than that of 20℃ group,and that in groups of each 196℃ were greater than that in groups of each 80℃.Conclusions Antifreeze can obviously keep activity of fat cells.Preservative effect of DMSO is better than trehalose,and that of both combination is much better.Liquid nitrogen storage of adipose tissue for three months and fat granules stored at 80℃ for two months are still suitable for clinical use.

[Objective] This paper investigates the impact of early intervention of gestational diabetes mel itus(GDM) on pregnancy outcomes. [Methods] Samples are drawn from the GDM cases diagnosed in Zhejiang Tonglu Maternity and Child Care Hospital between Jan. 2010 and Dec. 2012. The treat-ment group includes 56 cases that were diagnosed with systematic prenatal examination and received early treatment, while the remaining 42 cases in the control group were detected only in later phase of pregnancy and stayed untreated, upon which comparisons of pregnancy outcomes are made. [Results] Early intervention of GDM greatly improves the prognosis of both the mother and the perinatal stage infant, as demonstrated in statistical y significant dif-ference of complications. [Conclusion] Early intervention of gestational diabetes mel itus can reduce the chance of gestational complications, and further im-prove pregnancy outcomes.