Objective To observe the effects of the Dachaihu decoction on intra-abdominal pressure in severe acute pancreatitis. Methods 70 patients with SAP from China-Japan Friendship Hospital were randomly divided into two groups. 35 patients in a conventional treatment group were treated with conventional treatment of severe acute pancreatitis, and 35 patients in a Dachaihu decoction treatment group were treated with the decoction through nasogastric tube based on conventional treatment. The changes of intra-abdominal pressure and the morbidity of IAH and ACS in both groups were observed in acute stage. Results The intra-abdominal pressure in both groups increased. But the pressure in the Dachaihu decoction treatment group (13.31 ± 4.42 mmHg, 13.02 ± 5.23 mmHg, 12.35 ± 3.34 mmHg, 11.26 ± 4.46 mmHg, 9.89 ± 3.44 mmHg) was lower than the conventional treatment group (16.89 ± 5.71 mmHg, 17.52 ± 3.37 mmHg, 16.21 ± 2.15 mmHg, 14.57 ± 5.56 mmHg, 12.11 ± 1.28 mmHg) from the third day on (P<0.05). And the morbidity of intra-abdominal hypertension and abdominal compartment syndrome in the Dachaihu decoction treatment group were lower than the conventional treatment group in the whole acut stage (40%vs. 8.75%).The differences between two groups were statistically significant (P<0.05). Conclusion The Dachaihu decoction may significantly reduce the intra-abdominal pressure and the morbidity of intra-abdominal hypertension and abdominal compartment syndrome among patients with severe acute pancreatitis.

Objective: To investigate the curative effects of apoptin on the multidrug-resistant model, of human osteosarcoma cell line (R-OS-732). Methods: 363 bpVP 3 gene was cloned into the vector pIRES1 and the recombinant eukaryon expression vector pIRVP3 was transfected into R-OS-732 cells with liposome. The expression of apoptin gene at transcription level was proved by RT-PCR. The pathological changes of the cells was observed by light microscope and electronmicroscope. The transfected R-OS-732 cells were collected after 48 hours. The genomic DNA extracted from the cells was observed by agarose gel electrophoresis. The apoptosis rate of the cells was analysed by flow cytometry. Results: The expression of apoptin gene at transcription level had been proved by RT-PCR. The construction changes of the two groups were obviously different under light microscope: most of R-OS-732 cells in the transfected group existed in form of being away from the bottom of the culture dish after 24 hours, in form of apoptosis after 48 hours and in form of necrosis after 72 hours; but those cells in the controlled group grow luxuriantly. And under electronmicroscope there was much change of cell nucleus between the two groups. DNA ladder of the transfected cells was observed through agarose gel electrophoresis only one band was observed in the controlled group; but bands of fragmented DNA observed in ositive control group. Flow cytometry analysis showed that the apoptosis rate of the cells in the transfected group was relatively higher than that of the controlls( P

Objective To investigate the influences of 5-azacytidine (5-Aza) with different concentrations on mesenchymal stem cells (MSCs) proliferation and differentiation into myoblasts. Methods Bone marrow-derived MSCs of 4 weeks Wistar rats were separated and purified, and then treated with 5-Aza with different concentrations. The growth ability of cell was assayed with methyl thiazolyl tetrazolium (MTT) method. The expression of skeletal muscle actin in MSCs was determined with reverse transcription polymerase chain reaction (RT-PCR) and electrophoresis after MSCs were induced. Results The cell proliferation was not affected by 0 and 1 ?mol ? L-1 5-Aza . There were expressions of skeletal muscle actin treated with 3 -12 ?mol ? L-1 5-Aza. Some cells were obviously enlarged at the 9th day after induction and myotubu-like cells were found at the 12th day when treated with 9 and 12 ?mol ? L-1 5-Aza. 20 - 30 ?mol ? L-1 5-Aza induced the toxic effect on proliferation of MSCs. With the increase of concentration, the proliferation ability of MSCs was weakened. Conclusion 5-Aza affects the expression of regulatory gene to the stem cells and regulate MSCs to orientationally differentiate into myotube-like cells.

BACKGROUND: At present, there are investigations on the expression of cytokines and adhesion molecular in ischemia-reperfusion injury at abroad,but they do not involve in the relative studies on endogenous cytokines and adhesion molecular on microvascular endothelial surface following injury.The expression of endogenous interleukin-1(IL-1) is limited only at mRNA level.OBJECTIVE: To prove into the mechanism of the expression of intercellular adhesion molecular 1 and its regulation factor IL-1 in spinal ischemia-reperfusion injury.DESIGN: A randomized grouping design, animal experiment.SETTING: Department of Sports Medicine, College of Physical Education Affiliated to Jilin UniversityMATERIALS: This experiment was carried out at the Central Laboratory,China-Japan Union Hospital, Jilin University between March 2003 and January 2004. Totally 77 healthy male Wistar rats were randomly divided into normal control group (n=7), simple ischemia group (n=14) and ischemia-reperfusion group (n=56). Among the rats in the simple-ischemia group, 7 rats suffered from blood flow block for 30 minutes and 7 rats for 60 minutes; Rats in the ischemia-reperfusion group were assigned into 8 subgroups according to 8 time phases, respectively at reperfusion for 30,60 minutes, 2, 4, 6,9, 12 and 24 hours following spinal ischemia, with 7 rats at each time phase.METHODS: Spinal ischemia-reperfusion injury animal models were created with Zivin method. The expressions of vascular endothelial intercellular adhesion molecule-1 (ICAM-1) mRNA and IL-1β mRNA following spinal ischemia-reperfusion injury were detected with reverse transcriptionpolymerase chain reaction, immunohistochemistry and immunofluorescent confocal laser scanning microscope technique.MAIN OUTCOME MEASURES: The expression of IL-1β mRNA, activity of IL-1 polypeptide, expression of ICAM-1 mRNA and protein and activity of myeloperoxidase (MPO).RFSULTS: Totally 77 animals were enrolled and all of them entered the stage of result analysis. ① The expression of IL-1β mRNA (A value)was significantly higher in the ischemia-reperfusion group than in the simple ischemia group and normal control group, with significant difference (respectively 1.07±0.33,0.60±0.22,0.57±0.12,t=3.751 7,11.852 6,P ＜ 0.01).② Activity of IL-1 polypeptide (A value )was significantly higher in the ischemia-reperfusion group than in the simple ischemia group and normal control group, with significant difference [respectively (33.7±3.2),(23.8±4.5), (23.1±2.1),t=2.798 8,9.962 7,P ＜ 0.01]. ③ ICAM-1 mRNA(A value)was significantly higher in ischemia-reperfusion group than in simple ischemia group and normal control group, with significant difference[respectively 0.94±0.12,0.52±0.11,0.51±0. 10,t=0.327 0,6.127 4, P＜0.01].④The expression of ICAM-1 protein was significantly higher at ischemiareperfusion for 4,6 and 12 hours than in simple ischemia group and normal control group, with significant difference [Respectively (316.90±26.00),(361.40±18.00),(406.00±23.00),(164.21±2.00),(180.00±32.00) μg/L,t=1.410 3,9.119 3 ,P ＜ 0.01]. ⑤ The activity of MPO was significantly higher at ischemia-reperfusion for 12 hours than in simple ischemia group and normal control group, with significant difference [respectively (15.00±2.00),(7.50±1.67),(6.67±1.00) nkat/g, t=3.012 2,P ＜ 0.01].CONCLUSION: Following reperfusion injury, inflammatory reaction in spinal cord is important molecular basis for causing blood spinal barrier impairment, and plays an important role in the process of secondary spinal cord injury.

Objective To evaluate the correlation between serum procalcitonin (PCT) level and severity of diseases caused by different kinds of stress factors, and to identify the prognostic value of PCT on the prognosis in non-sepsis critically ill patients. Methods A retrospective case control study was conducted. The clinical data of non-sepsis critically ill patients with age of ≥ 18 years admitted to surgery intensive care unit (ICU) of China-Japan Friendship Hospital from August 2013 to December 2015 and stayed for more than 3 days were enrolled. The PCT level in the first 24 hours, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score and 28-day mortality were recorded. Patients were divided into different groups by the original injury, including trauma stress group, stroke stress group and non-infection inflammation stress group. According to PCT level, patients were divided into PCT normal group, low level group, medium level group and high level group. Furthermore, patients were divided into survival group and non-survival group according to 28-day prognosis. The clinical data of patients were compared among the groups, and the correlations among different markers were analyzed with Pearson or Spearman correlation analysis. The predictive value of PCT on prognosis of non-sepsis critically ill patients was evaluated with receiver operating characteristic curve (ROC). Results Ninety-four non-sepsis critical ill patients were enrolled, with 28 patients in trauma stress group, 30 in stroke stress group, and 36 in non-infection inflammation stress group, as well as 32 patients in PCT normal group, 18 in low level group, 18 in medium level group, and 26 in high level group. Of them, 78 survivors and 16 non-survivors were found. ① The PCT level of non-sepsis critically ill patients was significantly positively correlated with APACHE Ⅱ score and SOFA score (r1 = 0.688, r2 = 0.771, both P = 0.000). ② The PCT level in trauma stress group was significantly higher than that in stroke stress group and non-infection inflammation stress group [μg/L: 4.43 (0.86, 11.72 ) vs. 0.28 (0.16, 5.85), 2.39 (0.13, 4.11), both P < 0.01]. APACHE Ⅱ score (13.9±7.5, 13.9±7.0 vs. 9.4±4.4), SOFA score [7.0 (4.0, 9.0), 5.0 (3.0, 8.0) vs. 4.0 (2.0, 6.0)], and 28-day mortality [21.4% (6/28), 33.3% (10/30) vs. 0 (0/36)] in trauma stress group and stroke stress group were significantly higher than those of non-infection inflammation stress group (all P < 0.05). The abnormal rate of PCT in trauma stress group was significantly higher than that of stroke stress group and non-infection inflammation stress group [100.0% (28/28) vs. 33.3% (10/30), 66.7% (24/36), both P < 0.01]. ③ Non-survivors had significantly higher PCT level [μg/L: 6.02 (4.43, 18.34) vs. 0.76 (0.16, 4.11)], APACHE Ⅱ score (22.5±3.8 vs. 10.1±5.1) and SOFA score [9.0 (7.0, 11.0) vs. 4.0 (2.0, 8.0)] as compared with those of survivors (all P < 0.01). ④ APACHE Ⅱ score (7.8±2.8, 9.3±4.3, 13.7±6.2, 18.7±5.8, F = 22.495, P = 0.000), SOFA score [3.0 (1.2, 4.8), 4.0 (3.5, 4.5), 6.0 (3.5, 8.0), 10.0 (8.8, 12.0), Z = 51.040, P = 0.000], and 28-day mortality [0 (0/32), 11.1% (2/18), 22.2% (4/18), 38.5% (10/26), χ2 = 15.816, P = 0.001] were gradually increased as PCT level elevated. ⑤ The area under ROC curve (AUC) of PCT for evaluating prognosis of non-sepsis critically ill patients was 0.799 [95% confidence interval (95%CI) = 0.709-0.889, P = 0.000], when the cut-off value was 4.2 μg/L, the sensitivity was 87.5%, and the specificity was 77.6%. Conclusions Serum PCT level was positively correlated with severity of illness in non-sepsis critically ill patients, which had predicted value on prognosis. Trauma stress can lead to higher PCT level than stroke stress and non-infection inflammation stress can.

Objective To preliminarily investigate the clinical features and efficacy of surgical treatment of moyamoya syndrome in patients w ith hyperthyroidism. Methods From December 2002 to April 2013, 41 patients w ith moyamoya syndrome based on the disease of hyperthyroidism admitted to the Department of Neurosurgery, the 307th Hospital of PLA w ere analyzed retrospectively. The clinical data w ere colected, including sex, age of onset, initial symptoms, progress symptoms, imaging features, Suzuki staging, and surgical efficacy, and they w ere compared w ith the clinical data of the patients w ith moyamoya disease treated at the same time. Results The ratio of male to female w as about 1∶4 in moyamoya syndrome patients w ith hyperthyroidism. The peak age of onset w as 25 to 34 years old. Compared w ith the patients w ith moyamoya disease at the same period, the proportion of patients w ith cerebral infarction as initial symptom w as higher in the moyamoya syndrome group ( 39.0% vs.24.2%; χ2 = 4.796, P =0.029), more patients had symptomatic progression (46.3% vs.25.4%; χ2 =9.207, P =0.002), and the proportion of of patients w ith cerebral hemorrhage as initial symptom w as low er ( 2.4% vs.14.6%; χ2 = 4.829, P =0.028). Thirty-seven patients w ho received encephalo -duro-arterio-synangiosis (EDAS) w ere folow ed up for 43 ± 19 months. The results show ed that the clinical symptoms of 31 patients had different degrees of improvement. Conclusions Moyamoya syndrome of hyperthyroidism is more common in w omen. The risk of cerebral infarction is higher and more prone to have disease progression. The efficacy of EDAS is better for controling the progression of moyamoya syndrome in patients w ith hyperthyroidism.

Objective To study the effects of rehabilitation training on the expression of Nogo-A around the area of cerebral infraction using rats. Methods A total of 60 Wistar rats were randomly divided into a reha- bilitation group and a control group after an experimental cerebral infarction had been established in them. The ani- mals in the rehabilitation group were given exercise with a rotating bar, a balance beam and a rolling cage for one hour daily, while those in the control group were caged without any abnormal exercise. Nogo-A expression in the ar- ea surrounding the infarcts was detected by imunohistochemical techniques at the 3rd, 7th, 14th, 21st and 28th day after infarction. Meanwhile, neurobehavioral evaluations were also conducted. Results The animals in the rehabilitation group scored much lower than the controls in the behavioral evaluations at the 14th, 21st and 28th day. The expression of Nogo-A in tissues around the infracted area increased by the 7th day and peaked at the 21st day in both groups, but the expression of Nogo-A was significantly stronger in the rehabilitation group at the 14th, 21st and 28th days. Conclusion Rehabilitation training decreased the expression of Nogo-A in the brain of rats after infarction. This may have important implications for the functional recovery of the central nervous system.

Objective To investigate the accuracy of careful clinical evaluation in hemodynamic status and guidance of PiCCO monitor in clinical treatment.Methods A total of 96 hemodynamic unstable cases were evaluated prior to the insertion of the PiCCO catheter.The attending physician in charge of the patient was required to complete a questionnaire to predict the range of key hemodynamic variables for CI,GEDI,SVRI and EVLWI.Additionally,the attending was also asked to indicate a plan for therapy based on the predicted hemodynamic profile and decide if the predicted therapy plan was altered after the the first measurement of hemodynamic variables.Results The accurate prediction of hemodynamic variables was CI (55.2％),GEDI(60.4％),SVRI(63.5％) 和 EVLWI (78.1％),among which EVLWI had a higher accuracy(P ＜ 0.05).49％ doctors altered their planned therapy according to the result of the PiCCO information.Doctors had more difficulty in accurately predicting hemodynamic values in critical patients which APACHE Ⅱ scored 15 ～25 (42.3％ vs 67.9％ and 42.3 ％ vs 75.0％,x2 =4.755,5.231,P ＜ 0.05).The prediction of patients with acute myocardial infarction was more accurate than those of without acute myocardial infarction,and less to alter the planned therapy(21.1％ vs 55.8％,x2 =7.382,P =0.007).The patients of impaired oxygenation had less accurate predictions and less therapy alterations(32.3％ vs 56.9％,x2 =5.110,P =0.024).Attending was able to predict the hemodynamic status more accurately(63.9％ vs 40％,x2 =5.152,P =0.023) and alter the predicted therapy less(39.3％ vs 65.7％,x2 =6.189,P =0.013) in patients who were enrolled later.Conclusions Clinical evaluation in hemodynamic status of critically ill patients had a lower accuracy,the information obtained by PiCCO often instruct clinical doctors to choose the optimal treatment.

Objective To investigate the clinical features of subarachnoid hemorrhagic moyamoya disease and the therapeutic effect of encephalo-duro-arterio-synangiosis (EDAS). Methods The clinical and imaging data of 38 patients with subarachnoid hemorrhagic moyamoya disease admitted to the Department of Neurosurgery,the 307th Hospital of PLA from January 2002 to April 2013 were analyzed retrospectively. Thirty-five patients underwent unilateral or bilateral EDAS (64-sides underwent EDAS,4 patients with aneurysms underwent endovascular embolization first),and 3 patients did not undergo any surgery. Results (1)Subarachnoid hemorrhagic moyamoya disease accounted for 10. 8%(38/353)of all the hemorrhagic moyamoya disease admitted in hospital over the same period,including 37 adults and 1 child. The male to female ratio was 1∶3. 22 (9/29),and the age of onset was 12 to 59 years. The mean age of patients was 39 ± 11 years. Four patients were combined with aneurysms. There were no significant differences in the distribution of Suzuki stage,anterior choroidal artery dilatation and posterior communicating artery dilatation in the remaining 34 patients without aneurysms between the bleeding sides and non-bleeding sides (P>0.05). (2 ) The patients were followed up for 13 -125 months (mean 51 ± 27 months ),two patients had rebleeding,one of them was intraventricular hemorrhage,the other was parenchymal hemorrhage. The postoperative modified Rankin score (mRS)was significantly lower in 35 patients whom were treated with EDAS. Compared with before surgery,there was significant difference (P<0. 05). The re-examination of positron emission tomography (PET)for 16 patients at 3 to 19 months after surgery showed that among the 23 surgically treated hemispheres,the cerebral metabolisms of 17 hemispheres were improved after surgery, and 6 did not have any change after surgery. The re-examination of whole brain digital subtraction angiography (DSA)at 5 to 30 months after surgery in 13 patients showed that revascularizations in 19 of 23 surgical hemispheres were effective. Conclusion Subarachnoid hemorrhagic moyamoya disease often occurs in adults,and women are more common. EDAS can achieve good revascularization effect and improve brain metabolism of patients,and thus relieve the symptoms of cerebral ischemia.

Objective To investigate the value of central venous pressure (CVP) combined with visual left ventricular ejection fraction(LVEF) as an indicator of fluid responsiveness in patients with septic shock.Methods A retrospective analysis of 83 patients with septic shock receiving fluid challenge was conducted.The hemodynamic changes were evaluated with the pulse indicator continuous cardiac output (PiCCO) monitor,and all the patients were divided into two groups:the responded group (△CI％ ≥15％)and the unresponded group(△CI ＜ 15％),according to the change in CI(△CI％).Those patients were divided into several subgroups,including low CVP group (CVP ＜ 8 mmHg) and high CVP group (CVP ≥ 8 mmHg),low LVEF group(LVEF ＜ 50％) and high LVEF group(LVEF ≥ 50％),according to the initial value of CVP and LVEF.The changes in hemodynamic variables were compared before and after fluid challenge in each subgroup.The ability of CVP and visual LVEF was evaluated to predict fluid responsiveness with receiver operating characteristic curves.Results Fifty three (63.9％) patients responded to the fluid challenge,and lower CVP and higher LVEF patients were more frequency in responded group.The threshold value of 8 mmHg CVP for prediction of fluid responsiveness revealed the area under the curve (AUC) of 0.646 (P =0.219),and 50％ visual LVEF revealed AUC of 0.729 (P =0.023).CVP in combination with visual LVEF for prediction of fluid responsiveness showed an AUC of 0.817 (P =0.001) with a sensitivity of 76.3％ and a specificity of 88.2％.Conclusions Visual LVEF alone and combined with CVP can be used as an indicator of fluid responsiveness in patients with septic shock.