Tamm-Horsfall protein(THP)was determined with radioimmunoassay in the urine and blood samples of 59 burn patients.It was found that urine and blood THP was significantly decreased postburn and the degree of decresing was correlated with the extent of the burnt body surface and the severity of renal damage.The changes of THP occurred earlier than those of the routine parameters for renal damage such as BUN or Cr.It is suggested that THP determination can be used as an index for the early damage of the Henle's loop and the distal convoluted tubules after burn injury.

Electrolyte imbslance.the changes of serum aldosterone and the ratio of an-giotensin Ⅱ/arterial natriuretic peptide were studied prospectiely in 59 cases of severe burns.Meanwhile,certain parameters of renal functions were detarmined.Hypernatremia devaloped in 6 cases.On the basis of our findings,it is believed that postburn hypernatremia might result from renal dysfunction and the greatly increased mediators,which can enhance the retention of sodium,might also play an important role in the development of postburn hypernatremia.

Objective To evaluate the significance of MRI before surgery to remove polyaeryl-amide hydrogel (PAMHG) which has been used for augmentation mammaplasty. MethodsTwenty female patients with 40 breasts, having been injected PAMHG as augmentation mammaplasty, under-went bilateral breast axial T1WI, T2WI-fat saturation (FS) and sagittal T2WI-FS by 4-channal phased-assay breast coil at 3.0T (Philips) before removal surgery, in which 8 patients underwent axial multiphase contrast-enhanced MRI with THRIVE after Gd-DTPA (2.0 ml/s, 0.1 mmol/kg) adminis- tration. The results of MRI were compared with that of operation and pathology. ResultsPAMHG showed iso-intensity compared with breast gland on T1WI and hyperintensity on T2WI-FS. Low signal septa were noted within PAMHG in 40 breasts (20 patients), 90% (36/40) PAMHG without capsule, 10 % (4/40) with smooth capsule which showing homogenous low signal on T1WI and T2WI-FS. Subcutaneous lump of PAMHG was 70 % (28/40), lump of that in breast gland was 20% (8/40). Diffuse gel along spatium intermusculare of pectoralis major was 100 % (40/40), that along spatium intermusculare of intercostal muscle was 10 % (4/40). All PAMHG in breast of the 8 patients showed no enhancement, an irregular enhanced mass was found in gland of 1 patient. All distributions of PAMHG and appearances of its complications on T2WI-FS were consistent with the results of operation. ConclusionsT2WI-FS can accurately display the distribution of PAMHG and its complication before removal surgery. MRI plane scan combined with muhiphase contrast-enhanced MRI can differentiate PAMHG from the lesions in the gland and find the breast carcinoma, so that it can guide clinicians before surgery to remove PAMHG used for augmentation mammaplasty.

Objective To investigate the inhibitory effects of trichostatin A(TSA)on bladder cancer cell lines and its synergetic effect with anticancer drugs in treating bladder cancer in vitro and in vivo.Methods The inhibitory effects of TSA on human bladder cancer cell lines in vitro were detected by MTT assay.Hoechst staining was used to observe morphology for apoptotic cells after TSA treatment.Western blot was used to detect expression of acetyl-histone H3 and survivin.In vivo synergetic effects of TSA with anticancer drugs were detected in bladder cancer model rats.Results TSA significantly inhibited growth of bladder cancer cell lines in concentration and time dependent manner.Better results of tumor inhibition have been achieved when it was combined with DDP,MMC and ADM than used alone.After TSA treatment,the survivin expression in bladder cancer cells decreased and acetyl-histone H3 expression increased.Intravesical application of TSA combined with MMC can significantly inhibited tumor growth and progression.Conclusion TSA has direct anti-cancer effect and can enhance the action of several chemotherapy agents markedly.TSA may be an excellent candidate agent for intravesical application to treat bladder cancer.

Objective To evaluate and compare spiral CT and positron emission tomography-CT (PET-CT) in characterization of of axillary lymph nodes in breast cancer patients.Methods Forty patients with pathologically proven breast Cancer underwent contrast-enhanced spiral CT of tbe breast and axilla,13 of them also underwent PET-CT examination.One hundred and fifty-eight axillary lymph nodes were found in the 40 patients through contrast enhanced spiral CT,while 57 lymph nodes were found in the 13 patients through PET-CT.Three radiologists rated the lymph nodes found in CT images on a five-point scale.If the score was equal to or greater than 3,it was defined as positive (metastatic),otherwise negative.Visual observation and semiquantitative analysis were used to classify lymph nodes in PET-CT images.The results of spiral CT observation and PET-CT observation of lymph nodes were compared with pathological results.The relative value of CT and PET-CT was analyzed.Exact probability statistics were employed.Results One hundred and fifty eight lymph nodes of 40 patients were detected by spiral CT,91 of them were diagnosed as positive and 67 as negative Among the lymph nodes found in spiral CT,99 were positive and 59 were negative pathologicall.A total of 57 lymph nodes were found by PET-CT.Thirty-nine of them were defined as positive and 18 as negative.Among the lymph nodes found in PET-CT,39 were positive and 18 were negative pathologically.The sensitivity,specificity,accuracy,positive and negative predictive values in CT prediction in axillary lymph nodes metastases were 88.89%,94.91%,91.14%,96.70%,and 83.58%,respectively.The sensitivity,specificity,accuracy,positive and negative predictive values in PET-CT prediction in axillary lymph nodes metastases were 97.44%,94.44%,96.49%,97.44%,and 94.44%,respectively.PET-CT had no significant difference with spiral CT in sensitivity,accuracy,positive and negative predictive values for detection of axillary lymph nodes in breast cancer.But there was significant difierence between PET-CT and CT in negative predictive value(P＜0.05).Conclusions Both helical CT and PET-CT were the efficient methods in predicting the axillary lymph node status in breast cancer patiens.The negative predictive value of PET-CT was higher than that of helical CT.PET-CT has a better predictive ability than CT for the presurgical evaluation for breast cancer patients.

Objective To assess the value of coronal MPR of 64-slice spiral CT in investigation of the cause of bowel obstruction. Methods Thirty-eight patients with different kinds of bowel obstruction underwent 64-slice spiral CT examination, and the data of axial and coronal image were reconstructed. Then the images were analyzed respectively by 4 readers in group A and B. Doctors in one group viewed the axial images first, then the coronal images, while in the other group viewed the coronal images first and then the axial images. The CT findings were compared with the surgical and pathologic results. Results The accuracy of coronal MPR of 64-slice spiral CT for investigating the cause of bowel obstruction was similar to that of axial MPR (86.84% vs 89.47%), and both had high accuracy. Diagnostic accuracy and confidence of doctors were improved obviously with the combination of axial images and coronal images (both 94.73%). Conclusion Coronal MPR of 64-slice spiral CT has very high clinical application value for diagnosing bowel obstruction. Diagnostic accuracy and doctors' confidence are improved with the help of axial images.

Objective To report the clinical effects of microsurgery in treatment of infected extremities after blood vessel prosthesis were transplanted.Methods From Jan.1998 to Dec.2008,8 cases of major vascular injuries in extremities were blood-supplied by cross bridge vascular anastomosis from uninjured extremities,including 4 cases of femoral artery and vein,2 cases of popliteal artery and vein,and 2 cases of brachial artery and vein. Results After 3 years of follow-up,blood circulation of infected extremities were reestablished in each of 8 cases,as well as function and appearance recovered.Conclusion The procedure of cross bridge vascular anastomosis from uninjured extremities may efficiently restitute the blood supply of the infected extremities after blood vessel prosthesis were transplanted,and decrease the rate of amputation.

Objective To assess and compare the incidence,clinical characteristics,treatment,and prognosis of acute heart failure patients from different grades hospitals in Beijing.Methods In this prospective internet prognosis registered study (Beijing AHF Registry),a total of 3 335 consecutive patients admitted to 14 emergency departments in Beijing from January 1st 2011 to September 23rd 2012 were enrolled.According to hospital grade,these patients were divided into two groups,349 patients were from secondary hospitals,and 2 956 patients were from tertiary hospitals.Results Among the 3 335 patients,the medium age was 71 (58,79) years,and male accounted for 53.16％.The most common underlying disease were coronary disease (43.27％),hypertension (17.73％),cardiomyopathy (16.07％) etc.The average treatment time in Emergency Department was 66.82 h.The emergency department mortality rate was 3.81％ (127 cases).The 30-day and 1-year cumulative all-cause mortality were 15.3％ and 32.27％,respectively.The 30-day and 1-year cumulative all-cause readmission were 15.64％ and 46.89％,respectively.Compared with patients in tertiary hospitals,patients in secondary hospitals had more onset acute heart failure patients (63.64％ vs.49.93％),shorter emergency department treatment time (12 h vs.41 h),lower discharge rate (3.43％ vs.37.45％) and emergency department mortality(1.58％ vs.4.09％).Compared with those in tertiary hospitals,1-year cumulative all-cause mortality (25.6％ vs.33.2％),cardiovascular disease mortality (20.2％ vs.26.0％),aggravated heart failure mortality (22.4％ vs.28.8％) were lower in secondary hospitals.Following propensity score matching,compared to tertiary hospitals,patients in secondary hospitals showed lower utilization rate of beta-blockers and ACEFARB (4.51％ vs.28.17％,1.41％ vs.9.58％),except the pironolactone.Conclusion Acute heart failure in emergency department is associated with a high mortality rate and readmission rate.There is still a big gap between guidelines recommend medication current treatments for acute heart failure.

OBJECTIVETo explore the effects of hydrogen-rich saline (HS) on liver of severely scalded rats with delayed resuscitation.

METHODSTwenty-four SD rats were inflicted with 40% TBSA full-thickness scald using a temperature-controlled scalding apparatus. The injured rats were divided into lactated Ringer's solution (RS) and HS groups according to the random number table, with 12 rats in each group. Rats in groups RS and HS were respectively resuscitated with an intraperitoneal injection of 4 mL × kg⁻¹ × %TBSA⁻¹ of RS or HS (self-prepared, with concentration of hydrogen 0.6 mmol/L) 6 hours after injury up to 48 hours after scald. The infusion volume of the second 24 hours after injury was a half of that of the first 24 hours. At post scald hour (PSH) 6 (before resuscitation), 12, 24, and 48, blood was collected from the heart of 3 rats in each group, and then the rats were sacrificed for harvesting liver tissue. The pathological change in liver tissue was observed with HE staining. The number of hepatic neutrophils was counted with a hematocytometer. Serum levels of AST and ALT were determined with full-automatic biochemical analyzer. Contents of TNF-α, IL-1β, IL-6, and 8-hydroxy-2'-deoxyguanosine (8-OHdG) in liver tissue were determined with ELISA. Absorbance value of malondialdehyde (MDA) in liver tissue was detected and quantified with spectrophotometer. Data were processed with analysis of variance of repeated measurement and LSD-t test.

RESULTSAt PSH 48, moderate infiltration of inflammatory cells and hepatic hyperemia were observed in rats of group HS as compared with group RS. At PSH 12, 24, and 48, the number of neutrophils in group HS was respectively (25.3 ± 1.8) × 10⁵, (19.6 ± 0.6) × 10⁵, and (14.1 ± 3.2) × 10⁵ cells per mililitre, and they were significantly lower than those in group RS \[(31.9 ± 2.0) × 10⁵, (30.9 ± 2.2) × 10⁵, and (23.8 ± 3.0) × 10⁵ cells per mililitre, with t values respectively 5.6, 7.6, and 8.7, P values below 0.05\]. At PSH 6 and 12, the serum levels of AST and ALT and the levels of TNF-α, IL-1β, and IL-6 in liver tissue were close between the two groups (with t values respectively 0.3-3.9 and 0.9-3.8, P values above 0.05). At PSH 24 and 48, the serum levels of AST and ALT in group HS were respectively (308 ± 24) and (210 ± 15) U/L and (93 ± 7) and (70 ± 5) U/L, which were significantly lower than those in group RS \[(541 ± 39) and (505 ± 18) U/L, with t values respectively 17.5 and 16.7, P values below 0.05; (156 ± 9) and (166 ± 21) U/L, with t values respectively 30.3 and 6.9, P values below 0.05\]. At PSH 24 and 48, the levels of TNF-α, IL-1β, and IL-6 in liver tissue in group HS were respectively (20.7 ± 1.6) and (13.7 ± 1.5) pg/mg, (7.7 ± 1.5) and (6.3 ± 1.2) pg/mg, and (8.7 ± 1.2) and (6.0 ± 2.0) pg/mg, which were significantly lower than those in group RS \[(32.7 ± 5.0) and (25.7 ± 4.0) pg/mg, with t values respectively 5.2 and 5.7, P values below 0.05; (16.3 ± 2.5) and (12.0 ± 2.7) pg/mg, with t values both as 4.7, P values below 0.05; (14.7 ± 2.1) and (13.3 ± 1.5) pg/mg, with t values respectively 10.4 and 4.4, P values below 0.05\]. The level of MDA at PSH 6 and levels of 8-OHdG at PSH 6 and 12 in liver tissue were close between the two groups (with t values respectively 0.1, 0.7, and 4.3, P values above 0.05). In group HS, the levels of MDA in liver tissue at PSH 12, 24, and 48 were respectively (15.3 ± 1.5), (8.7 ± 1.2), and (6.7 ± 1.5) mmol/mg, and the levels of hepatic 8-OHdG at PSH 24 and 48 were respectively (124 ± 12) and (79 ± 10) pg/mg, which were significantly lower than those in group RS \[(27.3 ± 4.7), (20.3 ± 1.5), and (14.0 ± 1.0) mmol/mg, with t values respectively 5.2, 5.7, and 5.1, P values below 0.05; (191 ± 10) and (136 ± 15) pg/mg, with t values respectively 8.0 and 8.1, P values below 0.05\].

CONCLUSIONSResuscitation with HS could protect liver of severely scalded rats with delayed resuscitation possibly by reducing infiltration of neutrophils, thus lowering the content of inflammatory cytokines, and effectively alleviating oxidative stress.

Animals ; Burns ; metabolism ; physiopathology ; Deoxyguanosine ; analogs & derivatives ; blood ; Hydrogen ; pharmacology ; Interleukin-6 ; Liver ; drug effects ; metabolism ; physiopathology ; Male ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Resuscitation ; Sodium Chloride ; pharmacology ; Soft Tissue Injuries ; Time Factors ; Tumor Necrosis Factor-alpha ; blood

ObjectiveTo systematically review the intervention effect of Chinese medicine on the structure and function of testicular Sertoli cells in animal models of impaired spermatogenesis. MethodThe databases， such as China National Knowledge Infrastructure （CNKI），VIP，Wanfang Data，EMbase，and Pubmed，were searched for experimental studies on the effect of Chinese medicine on the structure and function of testicular Sertoli cells in animal models with impaired spermatogenesis. The included studies were evaluated for risks of bias，and the outcome indicators were analyzed with RevMan and Stata software. ResultThirty studies were included，involving 37 randomized controlled trials （RCTs）. As indicated by the Meta-analysis results， compared with the model group，Chinese medicine increased sperm density（SMD=2.42，95% confidence interval（CI）［1.47，3.37］，P<0.000 01）， promoted sperm motility（SMD=2.35，95%CI ［1.70， 2.99］，P<0.000 01）， up-regulated the protein and mRNA levels of Vimentin （related to Sertoli cell cytoskeleton）， elevated the levels of Occludin and Claudin-11 （related to tight junction of blood-testis barrier）， boosted the levels of β-catenin and N-cadherin （related to adherens junction of blood-testis barrier）， raised the level of connexin 43 （Cx43， related to gap junction of blood-testis barrier）， improved the function of Sertoli cells， increased the serum content of Inhibin B （INHB）， and up-regulated the levels of testicular follicle-stimulating hormone receptor （FSHR）， INHB mRNA， androgen-binding protein （ABP） mRNA， transferrin（TF），stem cell factor（SCF），SCF mRNA，glial cell line-derived neurotrophic factor （GDNF），GDNF mRNA，bone morphogenetic protein 4（BMP4），and BMP4 mRNA （P<0.05）. ConclusionChinese medicine can effectively increase sperm density and motility of animal models of impaired spermatogenesis，and improve the structure and function of testicular Sertoli cells. However，affected by the quality of the included studies，the above conclusion needs to be further verified by relevant high-quality studies.