Objective To evaluate the effect of continuous renal replacement therapy (CRRT) on extracorporeal membrane oxygenation (ECMO)-induced expression of inflammatory factors in pig kidney.Methods Twenty-four adult pigs of either sex,weighing 25-32 kg,were randomly divided into 4 groups (n =6 each) using a? random number table:control group (group C),sham operation group (group S),ECMO group and CRRT group.Anesthesia was induced with ketamine,diazepam and atropine and maintained with ketamine and diazepam.The pigs were tracheotomized,intubated and mechanically ventilated.The left femoral arteries were cannulated for MAP monitoring.Heparin 150 U/kg was injected intravenously.Right femoral artery and left internal jugular vein were cannulated for blood-letting and fluid infusion.In ECMO and CRRT groups,ECMO was performed for 24 h starting from 1 h after cannulation,in addition CRRT was performed for 24 h simultaneously in ECMO group.The pigs were then sacrificed and kidney specimens were obtained for determination of the content of interleukin-1β (IL-1 β),IL-6 and tumor necrosis factor-α (TNF-α) by ELISA.Results There was no significant differ-ence in the content of IL-1β,IL-6 and TNF-α between C and S groups (P ＞ 0.05).Compared with C and S groups,the content of IL-1β,IL-6 and TNF-α was significantly increased in E and CRRT groups (P ＜ 0.01).Compared with group E,the content of IL-1β,IL-6 and TNF-α was significantly decreased in group CRRT (P ＜0.01).Conclusion CRRT can decrease ECMO-induced expression of inflammatory factors in pig kidney to some extent,indicating that it can alleviate the inflammatory responses in kidney.

Objective To investigate the clinical effect of lentinan and thymopentin injection combined with PTP chemotherapy in oral squamous cell carcinoma patients, and to observe the effect of lentinan on serum tumor specific growth factor ( TSGF) , IgG, IgA and IgM and quality of life in patients with oral squamous cell carcinoma .Methods The clinical data of 80 cases of oral squamous cell carcinoma ( postoperative lymph node metastasis) confirmed by operation and pathology were analyzed retrospectively, and the diagnosis and treatment were analyzed.The control group were treated with PTP regimen, 80 ~120 mg/m2 of cisplatin, 50 ~80 mg/m2 of teniposide on the first day, the second to fourth day, once daily +pingyangmycin 4~6 mg/m2 , once daily, 3 to 12 days, 3 weeks for a course of treatment, a total of 6 courses.In the control group based on the use of thymopentin injection 20 mg and lentinan 2 mg+5% glucose solution 250 mL intravenous infusion, chemotherapy 2 d before the start, infusion 14 d, 3 weeks for a course of treatment, a total of 6 courses, for the observation group;two groups were 40 cases.The levels of serum TSGF, IgA, IgG, IgM and CD3 +, CD4 +, CD8 +, NK cells and TSGF in the two groups before and after treatment were measured.The quality of life of the patients was investigated by hospital-made questionnaires.The clinical efficacy and side effects were analyzed.Results TSGF levels in the two groups were significantly lower than that before treatment, and the TSGF level in the observation group was (39.1 ±4.9)U/mL, which was significantly lower than that in the control group (52.3 ±5.8) U/mL(P<0.05).After treatment, the TSGF level in observation group was lower than that in control group [(39.1 ±4.9) U/mL vs. (52.3 ±5.8) U/mL](P<0.05).The CD3 +, CD4 +, NK, IgG levels in observation group were higher than those in control group and the CD8 +level in observation group was lower than that in control group (P<0.05).The scores of physical symptoms, sleep quality, mental state and social affection levels in observation group were higher than those in control group(P<0.05).The total efficacy in observation group was lower than that in control group (77.5% vs.45.0%, P<0.05).The adverse reaction rate was 20.0% in the observation group, which was significantly lower than that in the control group (P<0.05).Conclusion The use of lentinan and thymopentin injection combined with PTP chemotherapy in the treatment of oral squamous cell carcinoma has higher clinical efficacy and less adverse reactions.

Objective To evaluate the clinical features and efficiency of surgical treatment in elderly patients with parathyroid tumor.Methods Clinical data of 12 cases (aged 60-83 years) was retrospectively analyzed.Their main complaints varies individually,including bone and muscle trouble in 9 patients,abdominal problem in 7 ones,and kidney stone in 6 ones.PTH level ranged from 78 to 2850 μg/L,and calcium level 2.6-4.5 mmol/L.Parathyroidectomy was carried out in 8 patients,while extended excision of suspected tissues in 6 ones.Intraoperative PTH determination was routinely performed.Results A drop by at least 50％ in PTH level was achieved in all cases after 10 minutes of tumor-bearing tissues excision.A much improvement of main complaints was shown in all cases about 1 week postoperatively.During the follow-up period from 18 to 48 months,both PTH and calcium levels were still in normal range in 9 patients,relapse was noticed in two cases 1 or 2 years after operation respectively.One patient died even after successful excision of parathyroid tumor.Conclusions PTH and calcium level determination is advised in elderly patients with suspected parathyroid tumor,and surgical treatment is generally safe and effective.

Objective To investigate the effect of exogenous hydrogen sulfide on myocardial NF-κB signaling pathway in rats with hemorrhagic shock (HS).Methods Forty adult male rats,weighing 250-300 g,were randomly divided into 4 groups (n =10 each):sham operation group (Sham group),sham operation + NaHS group (Sham + NaHS group),HS group and HS + NaHS group.HS was induced by withdrawing blood from the femoral artery.After HS,NaHS 28 μmol/kg was injected intraperitoneally at 10 min before resuscitation in groups HS + NaHS and Sham + NaHS.MAP was monitored and recorded at 0,1.5,2,3,4 and 6 h after blood-letting.The rats were then sacrificed and hearts were removed for determination of phosphorylated IKKβ (pIKKβ),IκBα (pIκBα),NF-κB p65 (pNF-κB p65) and high-mobility group box 1 (HMGB1) and for examination of myocardial ultrastructure with light and electron microscope.Results Compared with Sham and Sham + NaSH groups,MAP was significantly decreased and the expression of pIKKβ,pIκBα,pNF-κB p65 and HMGB1 was up-regulated in HS and HS + NaHS groups (P ＜ 0.05).Compared with HS group,MAP was significantly increased and the expression of pIKKβ,pIκBα,pNF-κB p65 and HMGB1 was down-regulated in HS + NaHS group (P ＜ 0.05).The pathologic changes were attenuated in HS + NaHS group compared with group HS.Conclusion Exogenous hydrogen sulfide can attenuate myocardial injury induced by HS through inhibition of NF-κB signaling pathway and reduction of inflammatory response.

Objective To evaluate the effects of sirolimus on scopolamine-induced cognitive dysfunction in rats.Methods Thirty male Wistar rats,aged 3 months,weighing 200-250 g,were equally randomized into 3 groups:normal saline group (NS group),scopolamine group (SC group) and scopolamine + sirolimus group (SS group).Normal saline,scopolamine 0.8 mg/kg and sirolimus 3.5 mg/kg + scopolamine 0.8 mg/kg were injected intraperitoneally in groups NS,SC and SS,respectively,and the injection was continued for 14 consecutive days.The cognitive function was assessed by Morris water maze test on 15th day.After behavior test,the rats were sacrificed and the prefrontal cortex and hippocampus were harvested for determination of amyloid β protein (Aβ) and Tau protein expression.Results Compared with NS group,the escape latency was significantly prolonged,the ratio of time spent in the target quadrant was decreased,Aβ expression in prefrontal cortex and hippocampus was upregulated and Tau protein expression in prefrontal cortex and hippocampus was down-regulated in group SC (P ＜0.05 or 0.01).Compared with SC group,the escape latency was significantly shortened,the ratio of time spent in the target quadrant was increased,Aβ expression in prefrontal cortex and hippocampus was down-regulated and Tau protein expression in prefrontal cortex and hippocampus was up-regulated in group SS (P ＜ 0.05 or 0.01).Conclusion Sirolimus can significantly improve scopolamine-induced cognitive dysfunction in rats and the changes in the expression of Aβ and Tau protein in prefrontal cortex and hippocampus may be involved in the mechanism.

Objective To study the recombination type of B/C genotype in hepatitis B virus.Methods The PCR was applied to amplifed the whole genes of HBV through the serums of four chronic HBV carriers who come from Jinghong distict,Yunnan province.The whole HBV genomes were ligated with pMD18-T vector and trasformed to E.coli JM109.After the positive colones were picked up,the HBV genotypes and recombinated sites were discoved through sequenced the acquired positive colones.Results All the acquired sixteen HBV sequences from the four HBV carriers were genotype B which were combinated with genotype C in some region.There are two ways of the combinations.For the first one,a 496 bp fragment from genotype C taked place the genotype B at the place of nt1825 to nt2320 of precore C/C region.For the second way,a 695 bp fragment of genotype B taked place at the both sites of nt822 to nt1020 of P gene region and nt1825 to nt2320 of precore C/C region.Conclusion A new recombination type of B/C genotype in hepatitis B virus was reported for the first time.The new Bj subgenotype was combinated with genotype C not only at the region of precore C/C but also at the place of P gene region.

OBJECTIVETo explore the therapeutic effect of Chinese medicinal massage with nourishing-Shen and activating-blood manipulation in treating women with climacteric syndrome and its influence on endocrinal function.

METHODSSixty patients were assigned to two groups, the 40 patients in the treated group were treated by Chinese medicinal massage for 20 min once every other day; the 20 patients in the control group were treated by hormone replacement therapy with Premarin 0.625 g, once daily by oral taking. The therapeutic efficacy was evaluated after two-month treatment by changes of serum levels of estradiol (E2), follicular stimulating hormone (FSH), luteinizing hormone (LH), and Kupperman index before and after treatment.

RESULTSKupperman index showed that the total symptom score in the treated group was improved from 30.71 +/- 8.43 scores before treatment to 8.21 +/- 5.14 scores after treatment, with a decrement of 22.50 +/- 8.14 scores, which was higher than that in the control group, from 24.32 +/- 5.44 scores to 5.92 +/- 3.58 scores, with a decrement of 18.40 +/- 4.50 scores, the difference between them was statistically significant (t = 2.52, P = 0.014). The serum level of E2 increased in both groups significantly after treatment, from 20.23 +/- 20.78 ng/L to 54.34 +/- 24.26 ng/L in the treated group (t= -2.73, P = 0.006), and from 16.15 +/- 24.40 ng/L to 40.61 +/- 81.54 ng/L in the control group (t = -1.72, P = 0.086), but the difference between groups was statistical insignificant (t= -1.120, P = 0.263). As for levels of FSH and LH, their decrements in the control group (13.16 +/- 11.29 mlU/mL and 10.37 +/- 9.21 mlU/mL) were larger than those in the treated group (4.92 +/- 4.26 mlU/mL and 0.17 +/- 2.42 mlU/mL), respectively (t = - 2.49, P = 0.013; t = - 2.38, P = 0.017).

CONCLUSIONChinese medicinal massage manipulation could improve the Kupperman index of all the 13 symptoms in women with climacteric syndrome, and increase the E2 level in serum.

Adult ; Estradiol ; blood ; Estrogens, Conjugated (USP) ; therapeutic use ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Luteinizing Hormone ; blood ; Massage ; Menopause ; Middle Aged

Objective To explore the changes of pathogens and antibiotic susceptibility in a respiratory ward.Methods All pathogens isolated from patients in a respiratory ward from 2001 to 2005 and the drug susceptibility results were retrospectively analyzed.For patients with more than 1 isolates of the same species, only the first strain of pathogen was included for analysis. The isolation and identification procedure was based on guidelines for national clinical laboratories.The susceptibility test was performed by disk diffusion method.WHONET 5.3 software was used for statistical analysis.Results A total of 876 strains were analyzed.The majority was gram negative bacteria.MRSA prevalence was 72.4% and showed a trend of increase.No vancomycin resistant Staphylococcus aureus or Enterococcus was detected.Streptococcus pneumoniae was highly resistant to macrolides.The non-sensitivity rate to penicillin was 25.5%-66.7% over years.The resistance rate to levofloxacin was 22.2%-27.3%.Enterobacter and Acinetobacter baumannii showed stable susceptibility to imipenem.ESBLs-producing Esche- richia coli and Klebsiella pneumoniae accounted for 33.3%-38.9% and 14.3%-19.2% respectively.P.aeruginosa strains were relatively susceptible to ceftazidime, amikaein, cefoperazone-sulbactam, imipenem, piperacillin-tazobactam and cefepime. The sensitivity rate was 87%, 82.6%, 78.3%, 73.9%, 73.9% and 71.4% respectively in 2005.Conclusions The changes of pathogens and antibiotic resistance in the respiratory ward were consistent with the surveillance data in this country, which were influenced by underlying diseases, severity of illness and antibiotic use.Our data are useful for the guidance of rational use of antibiotics.

Objective: To observe the clinical efficacy of sinew-bone balancing manipulation in treating lumbar disc herniation (LDH) and offer clinical evidence to support the concept of paying equal attention to sinew and bone. Methods: Sixty LDH patients were randomized into an observation group and a control group, with 30 cases in each group. The observation group was treated with the sinew-bone balancing manipulation, and the control group received conventional Tuina (Chinese therapeutic massage) manipulation. The clinical efficacy and posterior muscle chain tone effect were compared between the two groups by observing the visual analog scale (VAS) score, Japanese Orthopaedic Association (JOA) score, and posture-associated indicators. Results: The total effective rate was 86.7％ in the observation group, higher than 76.7％ in the control group, but the between-group difference in efficacy was statistically insignificant (P>0.05). After treatment, the VAS and JOA scores, angle-dependent muscle tone indicator of the posterior muscle chain, and lumbar posture symmetry showed significant changes in both groups (P<0.05). The VAS and JOA scores, angle-dependent muscle tone indicator of the posterior muscle chain, and lumbar posture symmetry in the observation group were significantly different from those in the control group after treatment (P<0.05), but the between-group difference in the general posture symmetry was statistically insignificant (P>0.05). Conclusion: Both the sinew-bone balancing and conventional Tuina manipulations can reduce pain in LDH patients, improve lumbar function, and adjust the angle-dependent muscle tone coefficient of the posterior muscle chain and lumbar posture symmetry; except for the general posture symmetry of the posterior muscle chain, the sinew-bone balancing manipulation wins out over the conventional Tuina manipulation.

Objective To investigate clinical effectiveness and feasibility of adult liver transplantation using the left lobe.Methods We analyzed the clinical data of 9 recipients who underwent adult liver transplantation using left lobe from March 2007 to April 2011,including 5 cases receiving split liver transplantation and rest 4 cases receiving living donor liver transplantation.Mean graft weight was 444.6 g (325-570 g) and mean graft-recipient weight ratio was 0.886％ (0.65％-1.18％ ).The middle hepatic vein was reserved in 7 cases.Six cases underwent Laden back surgical and 3 cases underwent classical surgical procedures.During the operation,PVP of 4 cases exceeded 20 mm Hg (2.67 kPa),3 cases were subjected to splenic artery ligation and 1 case to splenectomy.All recipients after operation were treated with triple drug maimenance therapy of Tacrolimus,Mycophenolate Mofetil and corticosteroids.We followed-up the recipients long-term,and the incidence of vascular complications and biliary complications,patient and graft survival,restoration of liver function were observed.Results No serious complications occurred in 4 living donors subject to left lobotomy and the liver function had a good recovery.The median follow-up period of these 9 recipients was 15.7 months ( 1 month to 51 months).Overall 1-year patient and graft survival rate was 77.8％ (7/9).Two cases died after operation.In the remaining 7 cases,1 case had initial poor graft function,and cases had initial good graft function.The main complications after operation included biliary anastomotic strictures in 1 case,small-for-size syndrome in 1 case,portal vein thrombosis in 1 case,initial poor graft function in 1 case and abdominal infection in 2 cases.Conclusion With strict for selecting and good matching donor-recipient,adult liver transplantation using left lobe is safe and feasible.