Objective To investigate the effect of continuous renal replacement therapy (CRRT) combined with Rhubarb at early stage on inflammatory cytokine in the treatment of severe acute pancreatitis.Methods Fifty two patients with SAP were randomly divided into three groups,the conventional treatment group,the CRRT group,and the combined group.CRRT was inplemented in 48 h after the diagnosis of SAP.APACHE-Ⅱ score,mortality were compared before and after treatment.Double sandwich ELISA method was used to detect the levels of interleukin 22 (IL 22),IL-18 and tumor necrosis factor α(TNF-α).Results The clinical effect in combined group was better than other groups,and the mortality was lower than other groups,but the difference was not statisticaly different(P＞0.05).The levels of IL-22,TNF-α and IL-18 were not significantly different among three groups before treatment (P＞0.05).After treatment,the inflammatory factors decreased in all groups.The levels of IL-18,TNF-and IL-22 in CRRT group and combined group were significantly lower than those in control group (P＜0.05),and the combined group decresed most abviously(P＜0.05).There was no significant difference in APACHE Ⅱ score among the three groups before treatment (P＞0.05),while the APACHE-Ⅱ scores were significantly decreased after treatment,the difference was statistically significant (P＜0.05).After treatment,the APACHE-Ⅱ score of the combined group were significantly lower than the other two groups(P＜0.05).Conclusion The therapy of CRRT combined with Rhubarb at early period in SAP patients can better clean up inflammatory cytokines of IL-22,TNF-,IL-18,so that patients with SAP can get more clinical benefits.

Many studies have shown that the embolism caused by vulnerable atherosclerotic plaque is one of the major causes of ischemic stroke. However, there is still not a simple and precise method to identify the vulnerable plaques yet. This article reviews the various methods for detecting vulnerable plaques from the aspects of serology and imaging.

Stiff-person syndrome(SPS) is a rare neurologic disorder with autoimmune features.It is characterized by progressive,severe muscle rigidity or stiffness most prominently affecting the spine and lower extremities.It is frequently associated with diabetes and other autoimmune diseases.The diagnosis of SPS is based on clinical grounds,however,aided by electromyography and high serum titers of antibodies against glutamic acid decarboxylase.Intravenous immunoglobulin infusions,plasmapheresis and steroids provide additional and lasting benefit.Moreover,benzodiazepines,baclofen,tiagabine and botulinum toxin A can afford symptomatic relief.

Idiopathic intracranial hypertension,which often occurs among adult overweight women,is a kind of chronic intracranial hypertension without any certain causes.The patient usually present with headache and papilloedema,and normal of brain structure and the cerebrospinal fluid composition.As visual loss is the only serious outcome,both dietary management and medical treatment are helpful in the early time,but surgery should be required as soon as visual loss occurs.The recent clinical study on idiopathic intracranial hypertension was reviewed.

Objective T o explore the num ber of necrophagous flies and seasonal distribution of com m on necrophagous flies at present in B eijing. Methods T he specim ens of necrophagous flies w ere collected by the m ethods of anim al carcass, trapping and feeding. A nd the specim ens w ere observed and counted after the classification and preservation. Results T he necrophagous flies in B eijing belonged to 4 fam i-lies, 9 subfam ilies, 21 genera and 46 species, and 12 species of them w ere the first records in B eijing. T he necrophagous flies had the characteristics of regional and seasonal distribution. Conclusion T he data of seasonal distribution of necrophagous flies and com m on necrophagous flies in B eijing can provide refer-ence for related research.

BACKGROUND: The skill to culture osteoblasts primarily has been well developed, however, variousdigestive enzymes can affect membrane protein of osteoblasts when they are used on primary tissue separately.OBJECTIVE: To avoid the damage from enzyme to cell as best possible,digest cranial osseous tissue with collagenase in DMEM containing fetal bovine serum and carry out in vitro culture of osteoblasts, then observe the effect of collagenase in DMEM containing fetal bovine serum on the digestion of osteoblasts.DESIGN: Control experiment.SETTING: Department of Orthopaedic Surgery, Tongji Hospital Affiliated to Huazhong University of Science and Technology.MATERIALS: This experiment was carried out in the Department of Orthopaedic Surgery, Tongji Hospital Affiliated to Huazhong University of Science and Technology from March to December 2004. Two Japanese white rabbits with big ears that were pregnant for 28 days were used in the experiment.METHODS: Type I collagenase with the same batch number was prepared into 0.1% collagenase with fetal bovine serum and 0.1% collagenase without fetal bovine serum by using culture medium containing 0.15 volume fraction of fetal bovine serum and DMEM solution respectively, serving as the enzyme digestive juice A and B for experimental group and control group respectively. Abdominal delivery was performed to take ont the fetal rabbit which was at embryonic 28 days under aseptic condition.Then, craniums of fetal rabbits were dissected, rinsed and chipped into pieces. 5 mL solution A and 5 mL solution B were added into the experimental group and control group at 37℃, respectively. Culture solution containing 0.15 volume fraction of fetal bovine serum was gradiently diluted into 0,1,2 and 4 folds in each group, and continued to digest and culture osteoblasts. The cellular survival rate was measured with trypan blue staining, and the osteoblast and its purity were identified with alkaline phosphatase(ALP) staining. Cellular growth was observed under the microscope.MAIN OUTCOME MEASURES: ①Cellular survival rate of two groups was detected with trypan blue staining. ② Cellular purity of two groups was detected with ALP staining in the cells. ③Cellular growth was distinguished by observing cellular morphology under the microscope.RESULTS: ① Results of trypan blue staining: Through cell counting, the rate of cells, which refused to be stained, of the experimental group reached 98%, and the cellular survival rate was high; that of control group reached 95%, and the cellular survival rate was also very high. ② Results of ALP staining in the cells: The area of ALP staining positive of experimental group was not less than 95%, and cellular purity was very high; but that of control group was not more than 75%, and cellular purity was very low. ③ Observation results under the microscope: Cells of experimental group were well stacked, convex and stereoscopic, they grew prosperously and had enough nutrition; while those of control group were not significantly in comparison with experimental group.CONCLUSION: Collagenase containing fetal bovine serum is used to digest the osseous tissue of cranium of fetal rabbits, and the cultured osteoblasts have typical properties of osteoblasts with simple component and high survival rate.

Objective　To investigate radiographic features of pneumocystis carinii pneumonia(PCP)or Kaposi sarcoma(KS),which were the most common complications of AIDS after renal transplantation.Methods　Radiographic diagnosis and differential diagnosis of 2 cases with PCP and KS comfirmed by pathology were discussed by analysing the chest X-ray findings combined with revieuw of reference literature.Results　The two cases with anti-HIV antibody all had mediasinal lymphopathy.In the case of KS,the omental tuber or tubercle shadows and pleural effusion were found on both pulmonary fields.Conclusion　No characteristic chest radiographic meanifestations in AIDS,the definitive diagnosis depends on clinical laboratory examination and pathological examination.

BACKGROUND: At present, many problems deserve to be solved before clinical utilization of adipose tissue-derived mesenchymal stem cells (ADMSCs) such as complete differentiation from ADMSCs into cardiomyocytes and ADMSCs with or without specific function of cardiomyocytes. It is of significance to solve the problems including how to elevate the differentiation rate of ADMSCs into cardiomyocytes and how to elevate the homing and survival rate after transplantation for clinical utilization of stem cells.OBJECTIVE: To observe the differentiation of ADMSCs into cardiomyocytes after in vitro culture and induction.DESIGN: Randomized controlled observation.SETTING: Laboratory of Cardiology, General Hospital of Chinese PLA.MATERIALS: Adipose tissue was collected from abdominal operative patients at Department of General Surgery of General Hospital of Chinese PLA with the agreement of patients. Iscove's Modified Dulbecco's Medium (IMDM), type Ⅰ collagenase, 5-azacytidine (5-aza) and polyclonal antibody of specific anti-myocardial Troponin T (TnT) were purchased from Hyclon company, Gibco company, Sigma and Fujian Maixin Biotechnology Company, respectively.Monoclone antibodies of CD44, CD45, CD34, HLA2DR and factor-Ⅷ, Desmin, anti-α-striated muscle actin and anti-myosin heavy chain (MHC) were bought from Beijing Zhongshan Golden Bridge Biotechnology Limited Corporation. DAB stain, reverse transcription-polymerase chain reaction (RT-PCR) kit and atrial natriuretic peptide (ANP) radioimmunity kit were purchased from Beijing Zhongshan Golden Bridge Biotechnology Limited Corporation,Invitrogen and Radioimmunity Research Institute of Science and Technology Development Center of General Hospital of Chinese PLA, respectively.METHODS: The experiment was performed at the Laboratory of Cardiology, General Hospital of Chinese PLA from March 2005 to April 2006. ADMSCs were isolated and cultured by digestion and attachment culture method. The third generation of cells were determined by immunocytochemical method for surface molecule CD44, CD13, CD105, CD45,CD34, HLA-DR, factor Ⅷ and induced by addition of 5-aza into culture medium. On the 7th, 14th, 21st and 28th days, gene of GATA4 and Nkx2.5 were tested by reverse transcription-polymerase chain reaction (RT-PCR), and the concentration of atrial natriuretic polypeptide (ANP) were also examined by radioimmunoassay.MAIN OUTCOME MEASURES: Determination of cell surface marker, gene of GATA4 and Nkx2.5, and ANP concentration.and factor Ⅷ negative for the cultured cells. After induction for 7 days with 5-aza, no cells expressed Desmin,α-Sarcomeric Actin, Myocin heavy chain (MHC) and TnT, most cells were positive stained for CD44. After induction for 14 days, small amounts of cells displayed positive for Desmin,α-Sarcomeric Actin and MHC but still negative for TnT,while partial cells expressed positive CD44. After induction for 21 days, most cells were positive for Desmin,α-Sarcomeric after induction and no significant difference was found compared with that at the 7th day [(0.022±0.01) ng/L (P＞0.05].ANP concentration was respectively (7.92±0.21) and (8.12±0.50) ng/L at the 21st day and the 28th day (P＞0.05), but there was significant difference compared with that at the 7th day (P＜0.05).

BACKGROUND: As a group of primary cells,stem cells have the potentials of self-renewal and multi-directional differentiation, and can replace the damaged cardiomyocytes to construct new vessels, and enable the asthenic heart to obtain the blood pumping function again.This study summarized the progress of stem cell transplantation in treating cardiovascular diseasesDATA SOURCES:A computer-based online search of Pubmed database was undertaken to identify English articles published from January 2000 to December 2005, the keywords were "stem cell transplantation, cardiovascular diseases".STUDY SELECTION: The articles were primarily checked, and the references of each literature were looked up. Inclusive criteria:articles correlated with the classification and the transplanted pathways of stem cells,the present status,problems and prospect of its basic and clinical application in treating cardiovascular diseases. Exclusive criteria: repetitive study or Meta analysis.DATA EXTRACTION:Totally 50 relative literatures were collected, and 31 of them accorded with the inclusive criteria,and the other 19 were excluded due to the old or repetitive contents. Of the 31 involved literatures, 19 were about the classification of stem cells used in cardiovascular system, 1 about the transplanted pathways of stem cells, 8 about the application of stem cells in treating cardiovascular diseases, and 3 about the existing problems and prospect.DATA SYNTHESIS:With the continuous improvement of living level and aging, cardiovascular diseases have become the main causes for death and disability in modern society.Stem cells have the potentials of multi-directional differentiation, and have become the main seed cells for cell replacement therapy, and provided important investigative and applicating field for the treatment of cardiovascular diseases. At present, there are many stem cells to be used in cardiovascular system, including embryonic stem cells, umbilical cord blood stem cells, peripheral blood stem cells, bone marrow stem cells, skeletal muscle satellite cells, myocardial stem cells, adipose tissue-derived stem cells, etc. The common pathways for stem cell transplantation are direct injection into myocardium,intracoronary artery injection and intravenous injection.Stem cell transplantation can treat cardiovascular diseases by promoting angiogenesis and myocardial regeneration, decreasing myocardial apoptosis and reducing myocardial collagen, then ameliorate the cardiac function, and breakthrough and progress have been made in both animal models and clinical studies. However, problems sill exist to be solved, and there is agreat distance to the routine clinical application.CONCLUSION: Stem cells are the important fields of the basic research and clinical application for preventing and treating cardiovascular diseases,thus it will provide powerful theoretical and practical supports for the more effective prevention and treatment of cardiovascular diseases to solving the key points and difficulties in cardiovascular diseases.