Objective To evaluate endovascular embolization with Onyx in treating brain arteriovenous malformations(AVM) located in the centre-encephalic region.Methods Eighteen patients with AVM in the brain centre-encephalic region were treated with embolization by using Onyx.According to Drake criteria of the AVM type,small type was seen in 10,medium type in 6 and large type in 2 cases.By using Onyx as embolization material,a total of 24 endovascular procedures were carried out.Results After treatment,complete obliteration was obtained in 12 cases(66.7%),disability(symptoms worsened) resulted in 2 cases(11.2%) and no death occurred.In the medium type group and the small type group complete obliteration was seen in 3(50%) and 9(90%) cases respectively,the difference between the two groups was significant(P 2 cm and the patients with the feeding artery

Objective To approach the expression and significance of connection tissue growth factor(CTGF) in articular cartilage after full-thickness osteochondral defect on the medial femoral condyle in young and adult rabbits model.Methods Totally 25 young(at an age from 10 to 12 weeks) and 25 adult New Zealand white rabbits(at an age from 34 to 39 weeks) were randomly divided into 5 groups(n=5) ,control group,24-hour,1-week,4-week and 8-week after full-thickness cartilage injury groups.A rabbit model of spontaneous healing of full-thickness cartilage defect in the medial femoral condyle in both knees was reproduced.Macroscopic and histological morphous of repairs were observed in each age group during repair.mRNA and protein expression of CTGF were detected with RT-PCR and immunohistochemistry,respectively.Results The morphologically good repairs with hyaline-like cartilage appearance were observed in young rabbit,but formation of fibrous tissue in adult rabbit.The expression of CTGF mRNA was detected in all groups.Expression of CTGF mRNA was significantly higher in young rabbit than in adult rabbits(P

BACKGROUND: Rejection is the main cause of the failure in small intestine transplantation. Cellular immunity mediated by chemotatic factor and the receptor plays an important role in acute rejection. We regard chemokine receptor as target site to design the treatment, which may provide reference for the immunotherapy in clinical small intestine transplantation. OBJECTIVE: To observe the effect of chemokine receptor antagonist, regulated upon activation, normal T cell expressed and secreted (Met-RANTES), on the survival time and histopathological changes of allograft rats which have received heterotopic small intestine transplantation, and the coordinative effects of Met-RANTES used together with low-dose tacrolimus.DESIGN, TIME AND SETTING: Randomized complete-block design and controlled animal experiment, performed in the Department of Gastrointestinal Surgery, Xijing Hospital, the Fourth Military Medical University of Chinese PLA between September 2003 and March 2005.MATERIALS: 180 healthy adult male rats including 90 rats (donors) and 90 Wistar rats (recipients) were involved in this study. Heterotopic segmental small intestine transplantation was performed.METHODS: The rats were randomly divided into 3 groups with 30 rats for each group. Control group: Rats were treated with heterotopic small intestine transplantation alone; Met-RANTES group: Rats were treated with an intraperitoneal injection of Met-RANTES (200 μg/d) at 0-7 days after transplantation; Met-RANTES+low-dose FK506 group: Rats were treated with an intraperitoneal injection of Met-RANTES (200 μg/d)+tacrolimus (0.5 mg/kg/d) at 0-7 days after transplantation.MAIN OUTCOME MEASURES: Gross status and survival time were detected; in addition, every 6 rats were sacrificed at different time points, such as 1,3, 5, and 7 days after transplantation, to compare histopathological changes. RESULTS: Following transplantation, 90 Wistar rats (recipients) were all involved in the final analysis. The survival time median in the control group was 7.2 days (1.5), and all rats died of acute rejection and infection. Histopathological examination showed that mild, moderate and severe rejections were detected at day 3, 5, and 7 after transplantation, respectively. The survival time median in the Met-RANTES group was 19.2 days (16.4), which was significantly longer than the control group (P<0.01). The survival time median in the Met-RANTES+low-dose tacrolimus group was 30.9 days (9.0), and there were significant differences in survival rate as compared with control group and Met-RANTES group (P<0.01). While the rats in the Met-RANTES group and the Met-RANTES+low-dose tacrolimus group showed no obvious indication of rejection.CONCLUSION: Met-RANTES may obviously inhibit acute rejection following small intestine transplantation, effectively protect the function of grafts, and significantly prolong the survival time of the recipients. In addition, Met-RANTES may enhance the immunosuppressive function of low-dose tacrolimus.

BACKGROUND: Rejection is the main cause of the failure in small bowel transplant. Chemotatic factor RANTES and receptor mediated cellular immunity are very important in acute rejection.OBJECTIVE: To explore the immunosuppressive effect of early adopting chemokine receptor antagonist, Met-RANTES after small bowel transplant on acute allograft rejection and its coordinative effect with Tacrolimus (FK506).DESIGN: Randomized complete-block design, controlled animal experiment.SETTING: Department of General Surgery, the 451 Hospital of Chinese PLA; Laboratory of Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA; Electronic Microscope Center, School of Basic Medicine, Fourth Military Medical University of Chinese PLA.MATERIALS: This study was carried out in the Laboratory of Department of Gastrointestinal Surgery, Xijing Hospital,Fourth Military Medical University of Chinese PLA from September 2003 to March 2005. Totally 192 animals including 96 SD rats (donors) and 96 Wistar rats (recipients) were involved in this study. Heterotopic segmental small bowel transplantation was performed.METHODS: The transplant rats were divided into 4 groups averagely by the randomized complete block design: control group (allogeneic small bowel transplant untreated group), Met-RANTES group(200 μg/d, 0-7 days, i.p.), FK506 group [0.5 mg/(kg·d) ,0-7 days,i.p.], Met-RANTES + FK506 group [Met-RANTES, 200 μg/d,0-7 days,i.p.+ FK506 0.5 mg/(kg ·d),0-7 days, i.p.]. Rats in the latter 3 groups were intraperitoneally administrated after transplant within 7 days successively.Rats in the control group were not given any treatments before and after transplant. Postoperatively, gross status,survival time and immunocyte infiltration were observed. Pathological examination was conducted in 6 rats of each group on postoperative days 3, 5 and 7. Fluorescent staining and successive quantitative measurement were conducted to detect the expressions of intragraft RANTES, CD4+, CD8+ and CD25+ T lymphocyte. Survival duration of the rest 6 rats of each group was observed for 5 weeks.MAIN OUTCOME MEASURES: ① Survival time of rats in each group following transplant. ② Pathological changes of small bowel intragraft of rats in each group. ③ RANTES and T lymphocyte expressions of rats in each group.RESULTS: Following transplantation, 96 Wistar rats (recipient) were all involved in the final analysis. ①Compared with control group, the survival time of rats in Met-RANTES group, FK506 group, Met-RANTES + FK506 group was significantly longer (P ＜ 0.01). In addition, rats in Met-RANTES + FK506 group survived the longest. There were significant differences in survival rate as compared with Met-RANTES group and FK506 group (P ＜ 0.01). ②All rats in the control group died of acute rejection and infection. Histopathologic examination showed mild, moderate and severe rejection on the postoperative days 3,5 and 7, respectively. No obvious rejection was found in the rats in the Met-RANTES group, FK56 group and Met-RANTES+FK506 group on the postoperative days 3,5 and 7. ③Postoperatively, intragraft RANTES expression of rats was significantly higher in each time period in control group than in the other 3 groups (P ＜ 0.01), and its dynamic change was positively correlated with the process of acute rejection; The expression of intragraft RANTES, CD4+, CD8+ and CD25+ T lymphocytes of rats was significantly lower, respectively, in the Met-RANTES group and Met-RANTES+FK56 group than in the control group (P ＜ 0.01).CONCLUSION: Met-RANTES may obviously suppress acute allograft rejection in small bowel transplant, effectively protect the function of grafts, and significantly prolong the survival time of the recipients. In addition, Met-RANTES may enhance the immunosuppressive function of small dose of FK506[0.5 mg/(kg · d)].

BACKGROUND:Mild hypothermia can effectively ease secondary brain and spinal cord injuries, which has a definite protective effect on the central nervous system. Meanwhile, mild hypothermia is conducive to the proliferation, activation and growth of transplanted cells by improving the microenvironment of the injured spinal cord.OBJECTIVE:To investigate whether mild hypothermia intervention can regulate the proliferation and apoptosis of neural stem cells through the RhoA/ROCK pathway.METHODS:The neural stem cell injury model was prepared and randomly divided into two groups:normothermia group and mild hypothermia group. The mild hypothermia group was treated with mild hypothermia [(32.0±0.5) ℃] for 4 hours. Expression of RhoA, RHOCK, Nogo-A and NgR in neural stem cells was detected by RT-PCR and western blot assay. RhoA/RHOCK positive cells were observed by fluorescence microscope. The intracellular Ca2+ concentration in neurons was measured by laser scanning confocal microscopy.RESULTS AND CONCLUSION:The expression of RhoA, RHOCK, Nogo-A and NgR in neural stem cells at mRNA and protein levels was significantly lower in mild hypothermia group than in the normothermia group (P < 0.05). The intracellular Ca2+ concentration in the neural stem cells was lower in the mild hypothermia group than in the normothermia group (P < 0.05). The number of RhoA/RHOCK positive cells in the brain tissue of rats was significantly lower in the mild hypothermia group than in the in the mild hypothermia group (P < 0.05). To conclude, mild hypothermia regulates the proliferation and apoptosis of neural stem cells by inhibiting the RhoA/ROCK pathway.

Objective:To investigate the curative effect of different restorations for deciduous teeth defect of children.Methods:67 children with teeth defecting seriously and being unable to fill restore were enrolled from January 2011 to January 2015 and randomly divided into three groups,one group of patients accepted metal crown restoration (Group A,n=22),one group adopted ceramic inlay restoration (Group B,n=22),and the last one accepted silver amalgam filling (Group C,n=23),the curative effect and incidence of adverse reactions among three groups in the period follow-up were compared.Results:In the period of 18-month follow-up,6 patients of toothache,5 patients of food impaction and crevices between restorations and teeth,3 cases of gingival congestion,2 cases of secondary caries were observed in group C;3 cases of toothache,1 case of food impaction,gingival congestion,crevices between restorations and teeth and secondary caries were observed in group B;2 cases of toothache and food impaction,1 case of gingival congestion were observed in group A.The incidence of adverse reactions in group A and group B was lower than those in group C (P＜0.05),which was lower in group A than that in group B,but no significant difference was found between group A and group B (P＞0.05).Conclusion:The restoration of metal crown and ceramic inlay deserved popularization had better curative effect and safety for deciduous teeth defect of children than silver amalgam filling.

Objective To investigate the clinical value of serum glycyl-proline dipeptidyl aminopeptidase(GPDA)combined with carcino-embryonic antigen (CEA),carbohydrate antigen724 (CA724),carbohydrate antigen242 (CA242) in the early diagnosis of gastric cancer.Methods Collected in Changan hospital in patients with gastric cancer and atrophic gastritis patients and healthy subjects 60 cases,by TBA-120FR biochemical analyzer glycyl-proline dipeptidyl aminopeptidase (GPDA),chemiluminescence analyzer to detect the levels of serum CEA,CA724 and CA242,analysis of single detection and joint detection and the differences between the positive rate and sensitivity.Results The detection of GPDA in gastric cancer group was significantly lower than that in atrophic gastritis group and healthy control group,the difference was statistically significant (F=69.532,P=0.000).The results of CEA,CA724 and CA242 in gastric cancer group were higher than those in atrophic gastritis group and healthy control group,the difference was statistically significant (CEA:F=59.926,P=0.001;CA724:F=51.056,P =0.001;CA242:F =72.613,P =0.000).Serum GPDA,CEA,CA724 and CA242 single detection positive rate were 70 ％,45 ％,61.7 ％ and 50 ％.Tumor markers CEA,CA724,CA242 positive rate of three joint detection was 75％.Serum GPDA and tumor markers of CEA,the positive rate of CA724 and CA242 combined detection of four was 86.7％.The positive rate of three and higher than that of single detection,the difference was statistically significant (F=49.635,P=0.003).Serum GPDA,CEA,CA724 and CA242 single detection sensitivity was 70.2 ％,50.2 ％,67.3 ％ and 53.2％.Tumor markers CEA,CA724,CA242 three joint detection sensitivity was 85.6％.Serum GPDA and tumor markers CEA,CA724 and CA242 four joint detection sensitivity was 90.3％.The sensitivity was higher than the three items and the individual tests,and the difference was statistically significant (F=52.016,P =0.001).Conclusion GPDA joint CEA,CA724 and CA242 tumor markers detection can improve the positive rate and sensitivity in early diagnosis of gastric cancer,but it will not reduce the diagnostic specificity,the clinical diagnosis of early gastric cancer has important significance and value.

Revascularization technique is a favorable approach to solve the insufficient compensation of cerebral blood flow for intractable intracranial aneurysms that needed to occlude parent arteries.With the development microsurgical technique and the improving of patency rate of vasotransplantation,the efficacy of revascularization for the treatment of intractable intracranial aneurysms is also improving constantly.

Objectives To investigate the clinical significance of CYP2C19 genotype detection for antiplatelet therapy of elder cardiovascular and cerebrovascular diseases(CCVD).Methods We enrolled all elderly patients with either cardiovascular or cerebrovascular disorders who received clopidogrel as mono drug or in combination with another antiplatelet drug aspirin as secondary prevention for more than 12 months in our hospital from January to August 2015.Somatotypes of CYP2C19 genotypes of all participants were assessed to analyze the relapse of cardiac-cerebral vascular diseases in these patients.Results A total of 250 patients were enrolled,including 179 male and 71 female,with average age of (85.2 ± 7.9) years.Among these patients,there were 97 (38.8％) cases with EM CYP2C19 genotypes,110 cases(44.0 ％) with IM CYP2C19 genotypes,43 cases(17.2 ％) with PM CYP2C19 genotypes.When treated with clopidogrel for antiplatelet in secondary prevention process,the rate of the relapse in cardiovascular event was 34.9％ and higher in PM CYP2C19 genotype than in EM and IM CYP2C19 genotype (19.6 ％ and 15.5 ％,respectively) (x2 =7.251,P =0.027).This phenomenon was similar to patients who received stent implantation(x2=6.393,P =0.041).However,no statistically significant difference was observed in the recurrence rate of cerebral vascular disease between three different genotypes(EM 29.9 ％,IM 20.0 ％,PM 27.9％,x2 =2.880,P =0.237).Conclusions Our results highlight that CYP2C19 genotype might be a potential guidance for secondary prevention of cardiovascular and cercbrovascular disorders among elderly patients.Clopidogrel may be less effective in patients with SM CYP2C19 genotype than those with EM or PM CYP2C19 genotype for secondary prevention of cardiovascular disease.

Objective:To investigate the influence of chronic periodontitis on the clinic effect of implant restoration.Methods:Fifty-two cases of chronic periodontitis patients with 70 implants and forty-nine cases of periodontally healthy patients with 69 implants admitted into our hospital from July 2013 to June 2016 were named as observation group and control group respectively.The implants survival rates,marginal bone loss (MBL),modified plaque index (mPLI),modified sulcus bleeding index (mSBI),and peri-implant probing pocket depth (PD) as well as IL-1,IL-6 in peri-implant sulcular fluid of the two groups were detected and analyzed after loading of 1,3,6,12 months.Results:After 12 months of loading,no obvious difference was found in the implants survival rate between two groups (P＞0.05).After 1,3 months of loading,no remarkable change was found in mPLI,mSBI,PD,and MBL between two groups(P＞0.05),while mSBI,PD,and MBL in observation group were significantly higher than those of control group except of mPLI after 6 months of loading (P＜0.05).Additionally,after 1,3 months of loading,IL-β in control group was not detected,while IL-β in observation group was conspicuously higher than those of control group after 6 months of loading and IL-6 in observation group was significantly higher than that of control group after 3 months of loading (P＜0.05).Conclusion:Chronic periodontitis could decrease the clinical effect ofim-plant restoration,which was probably due to the occurrence ofperi-implantitis.