Objective To investigate the early changes of plasma levels of angiopoietin2 in patients with multiple trauma and the relationship between plasma levels of angiopoietin2 (Ang2) and endothelial injury as well as prognosis of patients in order to determine their clinical significance. Methods Patients with multiple trauma admitted to emergency department from January 2008 to January 2010 were enrolled. A total of 59 casualties met the criteria(admission within 1 h after trauma and age > 18 years), and were eligible for enrollment. Patients with heart, brain, liver, kidney and other organic diseases, diabetes, hypertension, tumor, acute and chronic infectious diseases , severe brain injury (CCS < 12 points) , anticoagulant and thrombolytic medicine used two weeks before trauma were excluded. Among 59 patients, 36 were males and 23 females. The average age was(32.3 ±11.5) years. Patients were divided into severe trauma group (ISS ≥16 points,n =29) , moderate trauma group (ISS < 16 points, n =30 ) judged by using injury severity score (1SS). Thirty healthy subjects were selected as controls, 19 male and 11 female, with age > 18 years and an average age of(33.5 ±10.6) years. All groups had comparable gender proportion and average age. The 10 mL peripheral blood sanple was collected within 10 minutes after arrival of patients to emergency department and the plasma was separated from blood. Enzyme-linked immunosorbent assay (ELISA) was used to detect the plasma levels of angiopoietin2, and the plasma levels of von Willebrand factor (vWF) and thrombomodulin (TM) were also detected. Data were expressed as mean ± standard deviation and were statistically analyzed by using SPSS version 13.0 statistical software. The differences in plasma levels of angiopoietin2 of patients in each group were analyzed by ANOVA and Newman-Keuls test. Levels of angiopoietin2 in fatal patients and survival patients were also compared by using t test. The relationships between angiopoietin2 and plasma levels of vWF as well as levels of TM were analyzed by Pearson correlation analysis. Changes were considered as statistically significant if P value was less than 0.05. Results The plasma levels of angiopoietin2 in severe trauma group (ISS scored 16 points) were significantly higher than those in moderate trauma group (ISS < 16 points) ( P < 0.05 ), and those in trauma patients of the two groups were both significantly higher than those in control group (P < 0.05). The plasma levels of angiopoietin2 in fatal patients were significantly higher than those in survivors (P < 0.05). Plasma levels of angiopoietin2 were significantly correlated with plasma levels of vWF and TM (P < 0.05). Conclusions The plasma levels of angiopoietin-2 significantly increase after multiple trauma, and correlate with the degree of trauma severity. The plasma levels of angiopoietin2 correlate with endothelial injury after multiple trauma, having important prognosis value in patients with multiple trauma.

Objective To introduce an ideal method of repairing of finger volar skin defect. Methods Thirty-five patients whose finger was repaired by second digit lateral shank flap through free transplantation of lateral defect were selected. Twenty-four cases were male and 11 cases were female, with age of 21 to 45 years old. Cutting injury was in 7 cases, crush injury was in 16 cases, degloving injury was in 9 cases, and firearm injury was in 3 cases. Skin defect area was 2.0 cm × 1.5 cm-4.0 cm ×2.5 cm. The course was 1 h to 5 d. Donor area was repaired by thick skin flap. Results The postoperative wound of 35 cases all healed in stage Ⅰ, and skin flap transplantation and the donor skin grafts survived. Twenty-nine cases received follow-up for 5-26 (14.5±5.0) months. The skin flap had good appearance and good texture, with two points discrimination of 5-8 (6.7±1.1) mm. According to the Chinese medical association upper part of the function evaluation trial standard: excellent was in 19 fingers, good was in 8 fingers, and the excellent and good rate was 93.1% (27/29). Walk, run, jump functions of donor foot were normal. Conclusions Repairing finger with the second digit lateral shank flap through free transplantation of lateral defect has small area damage, and damage to the area around the organization is small. The effect of repairing is good, and can achieve the aim of the palm side repairing.

ObjectiveTo study the impact of quercetin on LPS-stimulated macrophage inflammatory cytokine release.MethodsDetermined by MTT assay with different concentrations of quercetin on the activity of RAW 264.7 cells.Cells were divided into five groups:A (control group),B group (LPS intervention group),C (LPS+quercetin 50 μmol/L),D group (LPS+quercetin 150 μmol/L) and E group (LPS+quercetin 250 μmol/L).Cells expression of toll-like receptor 4 (TLR4) and myeloid differentiation factor 88 (Myd88) and NF-kappa B (p65) mRNA in each group was determined by real-time determination; Supematant IL-6 and TNF-α secretion level was tested by ELISA determination.ResultsThe quercetin at 0 to 250 μmol/L concentration range on the activity of RAW 264.7 cells did not significantly affect.Compared with the control group,quercetin can effectively reduce the level of LPS-induced TLR4 and of MyD88 and of NF-κB (p65) of rmRNA expression and supematant IL-6 and TNF-α secretion,and dose-dependent manner(P＜0.01).ConclusionQuercetin may reduce macrophage inflammatory cytokine secretion by inhibiting the activation of TLR-Myd88-NF-κB pathway.

BACKGROUND:No international reports had shown that statins were effective for the treatment of vascular cognitive impairment. However, Chinese studies concerning effects of statins on vascular dementia had a smal sample size, so no definite conclusion was obtained.
OBJECTIVE:To perform a meta-analysis on effects of statins on vascular cognitive impairment, the methods recommended by the Cochrane Col aboration were used.
METHODS:The databases such as China National Knowledge Internet, Wanfang, VIP, Chinese Biological and Medical Database and PubMed Medline were searched by computer and manual y for randomized control ed trials about the effect of statins on vascular cognitive impairment. Retrieval time was from foundation to January 2013. The studies were screened according to the inclusion and exclusion criteria and then the data were extracted. The methodological quality of included studies was assessed and meta-analysis was performed by Revman 5 software.
RESULTS AND CONCLUSION:This study final y included 15 randomized control ed trials, a total of 1 203 patients, including 616 in statins group and 587 in control group. The fixed and random effect models were used to analyze mini-mental state examination and activity of daily living scales including 14 scoring method and the Barthel index score. Compared with the control group, mini-mental state examination scores in the patients of statins group (14 randomized control trials, 1 112 patients) were, mean difference (MD)=3.02, 95%confidence interval (CI):2.26 to 3.77, P<0.000 1;activity of daily living scores (14 scoring method, 7 randomized control ed trials, 513 patients) were, MD=-4.14, 95%CI:-6.11 to-2.18, P<0.000 1;the Barthel index scores (2 randomized control ed trials, 171 patients) were, MD=11.62, 95%CI:9.78 to 13.46, P<0.001. Our study mentioned a total of 14 cases of adverse reactions. One case was in control group, and the other 13 cases were in statins group which were al caused by atorvastatin. There were no serious adverse reactions in statins group and the rate of adverse reactions was 2.1%. The current evidence suggested that statins can improve cognitive function in patients with vascular cognitive impairment, with good safety. However, further conclusion stil requests higher quality of randomized control ed trials.

Objective To observe the results of 45 cases with acquired immunodeficiency syndrome(AIDS) genotypic viral resistance test(GT) assay.Method The technitues provided by AB Applied Biosystem was used to check the mutations in the reverse transcriptase associated with significant viral resistance.Results Fourteen cases out of 40(35%)cases which failed from first line regimen showed resistance to both zedovudine(ZDV) and lamivudine(LMV),and 26 cases out of 40(65%) cases showed resistance to ZDV or lamivudine used in the first line.For no-nucleoside reverse transcriptase in habitor(NNRTIs),11 cases out of 40(27%) cases had resistance to nevirapine(NVP),29 cases out of 40(63%) cases showed resistance to both NVP and efairavir(EFV).Two cases out of 5 which failed from second line regimen showed that one drug from both first and second line had no resistance,so it still could be used in the new regimen.Conclusion GT assay is very useful for choosing a best and personalized regimen for AIDS patients.

It was reported that three cases of neuropsychiatric complications after liver transplantation were enrolled from Department of Hepatobiliary Surgery,Weifang People's Hospital from March 2001 to August 2004. Two cases of delirium kind of mental disorder,and one patient had epilepsy and limb movement disorder. All subjects were mainly given immunosuppressant drug therapy,a timely correction of fluid and electrolyte imbalance and symptomatic treatment. Postoperative prognosis of patients as well as the diagnosis and treatment of patients were retrospectively observed. Case one,male aged 54 years of hepatitis B liver cirrhosis and large,with a history of hypertension for 15 years and diabetes for 10 years. On September 25th,2001 the patient received piggyback liver transplantation. During and after transplantation the patient received a strong impact on the treatment with the Dragon 1 000 mg. After 28 days,the patient died of hyperbilirubinemia,hyperkalemia,liver and kidney failure clinically. Case two,male aged 47 years of hepatitis B,cirrhosis and huge hepatocellular carcinoma,chronic calculous cholecystitis,with a history of hypertension for 5 years and diabetes for 2 years. On December 26th,2001 the patient was treated with piggyback liver transplantation. At day 44 the patient had obvious cough with yellow-green phlegm,sputum culture was Aspergillus spp (50%) and diflucan for the treatment. Till day 53,drowsiness and depressed spirit appeared; at day 54,the patient was disoriented,and at day 55 hemiparesis occurred at right side,gradually coma,by brain CT scan it confirmed to be intracerebral hemorrhage,and died. Case three,male aged 59 years of hepatitis B,cirrhosis of liver atrophy with right hepatic small hepatocellular carcinoma. On August 20th,2004 the patient was given classic modified line-situ liver transplant surgery without venovenous bypass. Four days after sudden aphasia,gradually motor dysfunction,swallowing dysfunction,restlessness and epilepsy appeared. After Phenytoin Sodium,chloral hydrate enema and luminal sodium treatment,focal epilepsy and irritable symptoms were effectively controlled,but aphasia and left hemiparesis still occurred. After five months,the patient died of cerebral hemorrhage. Incidence rate of neuropsychiatric complications are high after liver transplantation. Besides,brain hemorrhage is a serious complication and has a high mortality rate. It is important and positive of reducing bleeding,maintaining hemodynamics and environmental stability to avoid the large blood transfusion and infusion for the prevention of serious complications.

It was reported that three cases of neuropsychiatric complications after liver transplantation were enrolled from Department of Hepatobiliary Surgery, Weifang People's Hospital from March 2001 to August 2004. Two cases of delirium kind of mental disorder, and one patient had epilepsy and limb movement disorder. All subjects were mainly given immunosuppressant drug therapy, a timely correction of fluid and electrolyte imbalance and symptomatic treatment. Postoperative prognosis of patients as well as the diagnosis and treatment of patients were retrospectively observed. Case one, male aged 54 years of hepatitis B liver cirrhosis and large, with a history of hypertension for 15 years and diabetes for 10 years. On September 25th, 2001 the patient received piggyback liver transplantation. During and after transplantation the patient received a strong impact on the treatment with the Dragon 1 000 mg. After 28 days,the patient died of hyperbilirubinemia, hyperkalemia, liver and kidney failure clinically. Case two, male aged 47 years of hepatitis B, cirrhosis and huge hepatocellular carcinoma, chronic calculous cholecystitis, with a history of hypertension for 5 years and diabetes for 2 years. On December 26th, 2001 the patient was treated with piggyback liver transplantation. At day 44 the patient had obvious cough with yellow-green phlegm, sputum culture was Aspergillus spp (50%) and diflucan for the treatment. Till day 53, drowsiness and depressed spirit appeared; at day 54, the patient was disoriented, and at day 55 hemiparesis occurred at right side, gradually coma, by brain CT scan it confirmed to be intracerebral hemorrhage, and died. Case three, male aged 59 years of hepatitis B, cirrhosis of liver atrophy with right hepatic small hepatocellular carcinoma. On August 20th, 2004 the patient was given classic modified line-situ liver transplant surgery without venovenous bypass. Four days after sudden aphasia, gradually motor dysfunction, swallowing dysfunction,restlessness and epilepsy appeared. After Phenytoin Sodium, chloral hydrate enema and luminal sodium treatment, focal epilepsy and irritable symptoms were effectively controlled, but aphasia and left hemiparesis still occurred. After five months, the patient died of cerebral hemorrhage. Incidence rate of neuropsychiatric complications are high after liver transplantation. Besides, brain hemorrhage is a serious complication and has a high mortality rate. It is important and positive of reducing bleeding, maintaining hemodynamics and environmental stability to avoid the large blood transfusion and infusion for the prevention of serious complications.

Objective To compare the therapeutic efficacy of 125Iodine seed implantation and gamma knife in treating portal vein tumor thrombosis (PVTT) in hepatocellular carcinoma (HCC), and to discuss their clinical applications. Methods Between January 2009 and May 2013, a total of 60 HCC patients associated with PVTT were encountered at authors’ hospital. The patients were divided into gamma knife group (n=30) and 125Iodine seed group (n = 30). Gamma knife treatment was carried out for the patients of gamma knife group. A total of 3 - 10 target points were designed. Single dose of 3 - 6 Gy per fraction was used and 2 - 5 times radiotherapy every week were conducted. The total treatment dose was 30 - 50 Gy. In designing the therapeutic scheme, 50%-70%of iso-dose curve contained PTV. 125Iodine seed implantation was performed for the patients of 125Iodine seed group. After the treatment, the change of PVTT size was assessed. The clinical efficacy was evaluated. Results Three months after the treatment, in gamma knife group complete remission (CR) was seen in 0 patient (0%), partial remission (PR) in 8 patient (26.6%), stable disease (SD) in 17 patients (56.7%) and progressive disease (PD) in 5 patients (16.7%). In 125Iodine seed group, CR was obtained in 3 patients (10.0%), PR in 19 patients (63.4%), SD in 7 patients (23.3%) and PD in one patient (3.3%). Statistically significant differences in responding the therapy existed between the two groups (P < 0.05), although no significant difference in the improvement of ascites and hepatic function existed between the two groups (P<0.05). Conclusion For the treatment of portal vein tumor thrombosis of hepatocellular carcinoma, the short-term efficacy of 125Iodine seed implantation is much better than that of gamma knife, although its long-term effect needs to be further studied.

Objective To observe the specific cellular immune response induced by co-immunization of DNA vaccine of Mtb8.4 and plasmid encoding human interleukin 12(hIL-12)in mice.Methods Fifteen C57BL/6N mice were divided into following groups:Mtb8.4 gene vaccine plus plasmid of hIL-12,Mtb8.4 gene vaccine,BCG,empty vector alone and PBS.Mice were immunized intramuscularly in both hind limbs three times at the intervals of three weeks or once subcutaneously with 1?106 of viable M.bovis BCG Pasteur at the time of the first DNA immunization.The level of IFN-? in supernatant of spleno-lymphocyte cultures was measured by ELISA.CTL activities of spleno-lymphocyte were detected with LDH release assay.Results The levels of IFN-? and IL-2 in supernatant of spleno-lymphocyte cultures in the group of Mtb8.4 gene vaccine plus plasmid of hIL-12 were significantly higher than that of group of Mtb8.4 alone(P

Objective To prepare Mtb8.4 gene vaccine and to study the cellular immune response induced by the vaccine. Methods The gene encoding Mtb8.4 from Mycobacterium tuberculosis was amplified by PCR and cloned into the eukaryotic expression vector pcDNA3.1 (+). C57BL/6N mice were vaccinated three times with Mtb8.4 gene vaccine at 3 weeks interval. Four weeks after the final inoculation, mice were sacrificed to assess cytokine response and CTL induction. Results The IFN-? and IL-2 titers were 787.317?45.586pg/ml and 319.953?57.978pg/ml in Mtb8.4 gene vaccine group, 1 486.540?39.600pg/ml and 767.043?50.269pg/ml in BCG group, respectively. The level of IL-4 in BCG group (90.580?10.998 pg/ml) increased significantly as compared to other groups (P