Objective The mechanism of delaying flap with the minimal invasive surgery was approached to understand its effects on the whole delayed survival of skin flaps thoroughly so as to provide the rationale for its clinical use.Methods 80 male or female Wistar rats were randomly subdivided into two groups:delayed by the minimal invasive surgery,and immediately transfer without delay.Flaps in each group delayed were cut at 1,2,3 and 4 weeks,respectively.The flap was designed at the lower back of rat,with the size of 5 cm × 1 cm,crossing the middle area for 2.5 cm and including stem of iliac branch from iliolumbar artery.2 weeks after second operation,the survival area,capillary density and content of lactic acid of the flaps in each group were examined,and the survival of the falps delayed by the minimal invasive surgery was compared.Results The longer delaying time,and the higher survival rate were observed in the experimental group.Delaying for 3 weeks and 4 weeks,the survival rate was (86.13 ±1.13) ％,(93.49 ± 1.15) ％,respectively,in the experimental group.While in control group,the survival rate was no more than 63％.The longer delaying time,the higher the capillary density were noted in two groups,but 3 weeks delayed group equally matched to the 4 weeks delayed group.In the experimental group,the content of lactic acid increased peaked in 1 week delayed group,then fell-down gradually,but kept steady in 3 and 4 weeks delayed group.The content of lactic acid in the control group kept steady.Conclusions The experimental model is selected as cross-area axial flap on the lower back of rats.The minimal invasive surgery plays the same role as in delaying flaps,which causes vasoconstriction,resulting in disorder of internal environment,ischemia and hypoxia,finally vasodilatation.The more ramus anastomosis,the more survival rate of the flap.

Tissue plasminogen activator(tPA) had been used clinically as a choice drug for the therapy of ischemic shock.Evidence in animal experiments suggests that tPA may play a neurotoxic role in central nervous system(CNS) via the induction of microglial activation,degradation of laminin matrix and enhancement of the N-methyl-D-aspartate(NMDA) receptor-mediated signaling in neurons,other reports imply tPA could protect rat neuronal cells from zinc-induced toxicity.

The donated organ after cardiac death would undergo warn ischemia injury inevitably,and the incidences of primary non-function of donated organs,transplanted organ loss and ischemic-type biliary lesions were increased.It is a paramount research dilemma to devise how to avert,lessen and recover the warm ischemia organs after donation of cardiac death (DCD).Since February 2009,the Liver Transplantation Center of Guangzhou General Hospital of Guangzhou Military Command of PLA has applied the extracorporeal membrane oxygenation (ECMO) to protect the organs of DCD.The mechanism of recovering the donors from warm ishemia by ECMO has good prospects in the field of international organ donation,and it is an important method to solve the problem of donor shortage in China.Spreading the application range of ECMO in DCD and establishing the standard procedures and techniques in China is of great importance.

The incidence of early neurological deterioration in acute ischemic stroke is higher, and the clinical prognosis is poor. There is no effective specific prevention and treatment now. This article reviews the advances in research on early neurological deterioration in acute ischaemic stroke in recent years.

Objective To explore the differences of the proliferation ability and the antineoplastic activity of CIK cells against origenal hepatocellullar cancer cells between healthy adults and tumor patients in vitro. Methods Peripheral blood mononuclear cells (PBMC) from healthy donors and tumor patients were incubated to induce CIK cells in the presence of interferon gamroa(IFN-γ) ,IL-2 and anti-CD3 monoclonal antibody (mAb). The changes in the proliferation activity and phenotypes of the CIK cells were identified by flow cytometric analysis. Single cell suspension was prepared bom the fresh hepatocellular carcinoma tissue by using mechanical trituration method. MTT assays were used to determine the cytotoxicity of CIK cells against origenal hepatocellullar cancer cells. Results The CIK cells from both healthy donors and tumor patients were significantly increased with the extension of time. The expression rate of CD3+/CD56+ cells from healthy donors rose from 1.053% ±0.22% on 1st day ,25.36% ±2.19% on the 7th day to 55.12% ±1.99% on the 14th day ,which was significantly higher than that of tumor patients ( P ＜ 0.05). MTT assays showed that the cytotoxicity of CIK cells from both enhanced obviously with the addition of Effect/Target rate and extension of time(P ＜0.05). After the origenal hepatocellullar cancer cells were treated by CIK cells 24 hours, the cytotoxicity of CIK cells from healthy donors at the effector:target ratio of 10 ∶ 1,20 ∶1 and 40 ∶1 was significantly higher than that of tumor patients(P＜0.05) ,respectively. After treated 48 hours, compared with tumor patients, the cytotoxicity of healthy donors? CIK at the three effector:target ratio was alsosignificantly higher(P ＜0.05), respectively. Conclusion CIK cells from both have amplification ability and cytotoxic activity in vitro,and the proliferation ability and killing activity of healthy adults CIK is stronger than that of tumor patients,which provides an experimental basis for CIK to clinical application as an adoptive immunotherapy.

ObjectiveTo investigate the effects of extracts ofLiaoxuan Kaxifu Powders (LE) on proliferation and transcription of IL-8 and ICAM-1 in HaCaT induced by TNF-α; To discuss its mechanism of action.Methods Cultured HaCaT was assigned into normal group, TNF-α group and low-, medium- and high-dose of LE group. Every group was induced by 40 ng/mL TNF-α except for normal group, and then LE groups were treated by different concentrations (8, 40, 200μg/mL) of LE for 48 h. The proliferation of HaCaT was evaluated by MTT and the apoptosis was detected by inverted fluorescence microscope. Levels of IL-8 and ICAM-1 in HaCaT were assessed by ELISA, and their mRNA expressions was detected by semi-quantitative RT-PCR.Results Compared with normal group, the absorbency of HaCaT and the contents and mRNA expressions of IL-8 and ICAM-1 increased in TNF-α group (P<0.05,P<0.01); compared with TNF-α group, LE of all dose groups could significantly inhibit the absorbency, decrease the contents and mRNA expressions of IL-8 and ICAM-1 (P<0.05,P<0.01).Conclusion LE is able to inhibit the proliferation of HaCaT induced by TNF-α, and the mechanism is probably related to promoting apoptosis and down-regulating the gene expressions of IL-8 and ICAM-1, and then maintaining the normal level of HaCaT.

Objective To study the diagnosis and treatment of non-anastomotic biliary stricture (NABS) after liver transplantation.Methods The clinical data of 403 patients who underwent liver transplantation in the past 10 years in our department were analyzed retrospectively,compared different methods to find out the most appropriate method in the diagnosis and management of NABS.Results NABS occurred in 13 out of 403 patients (3.2％),almost the same incidence as in patients who received DCD donor livers (4.16％,2/48).The clinical signs of NABS were frequent cholangitis and high TBil,r-GT and AKP (P ＜0.01).All these cases were finally diagnosed by cholangiography and they could be classified into 3 types:hepatic bile duct stricture (4 patients,type Ⅰ),multiple extrahepatic and intrahepatic biliary strictures (7 patients,type Ⅱ),intrahepatic biliary strictures (2 patients,type Ⅲ).NABS were mainly treated by interventional therapy,Roux-en-Y anastomosis and retransplantation in our centre.All type Ⅰ patients were successfully managed with interventional therapy/ERCP and Roux-en-Y anastomosis,but 44.4％ (4/9) of type Ⅱ and Ⅲ patients required retransplantation.The TBIL,r-GT and AKP decreased significantly in 12 patients (P ＜ 0.05) and the total curative rate of NABS was 92.3％ (12/13) with one patient who died after retransplantation.Conclusions Cholangiography was an effective way to diagnose NABS which is common among patients after liver transplantation.Interventional therapy/ERCP,Roux-en-Y anastomosis and retransplantation were our 3 ways to treat this problem.We proceeded from easy to difficult and chose a suitable way to deal with NABS according to the different types of biliary stricture from cholangiography.Type Ⅰ patients had much better prognosis than Type Ⅱ and Ⅲ patients who should receive retransplantation if interventional therapy/ERCP failed.

Objective To investigate the role of nurses in civil cardiac death organ donation work.Methods Cooperating,propagating and promoting in civil cardiac death organ donation; building a bridge between the families of organ donation,donor coordinators,physicians and hospital ethics committees; participating in organ donation medical ethics assessment work; cooperating with the doctors do intend to maintain organ donation,access and preservation; protecting donors remains.Results During the time of July 2011 to November 2013,we successfully completed 52 cases of civil cardiac death organ donation cooperating with doctors,and got 41 liver,which entered the national organ allocation system for distribution.Conclusions The nurses will play a more and more important role in work of civil cardiac death organ donation cooperating with doctors.

Objective To detect by flow cytometry (FCM) acute myeloid leukemia. Methods Fourcolor staining was used for analysis of immunphonotypes of 52 cases with acute myeloid leukemia and 7 cases of mixed leukaemia. Results 52 cases with series of patients with AML expression, with the main expression CD13 (94.2 %), CD117 (90.4 %), cMPO (90.4 %) CD33 (86.5 %), CD34 (57.7 %), HLA-DR (53.8 %). In 7 cases of mixed cell leukemia 3 cases of myeloid/B (M/B), are expressing CD13, CD34, CD117, CD10, CD19, cMPO, cCD79a.Myeloid/T (M/T) 2 cases with expression of CD13, CD117, CD33, CD34, CD5,CD7, cMPO; B department/T (B/T) 2cases, with expression of CD5, CD7, CD10, CD19, CD20, CD34. And with the morphological and organizations with high accuracy of chemical diagnosis. Conclusion FCM can improve the diagnose rate for AML and mixed leukemia. And has played an important clinical significance.

Objective To detect double immuno-phenotype of acute leukemia by the application of flow cytometry (FCM). Methods Four-color FCM was used to analyse 23 cases of acute leukemia of double immune phenotype. Results Among 23 cases, cCD3 was expressed in 10 cases (43.4 %), cCD79a in 16 cases (69.6 %), cMPO in 20 cases (87.0 %), TdT in 14 cases (60.9 %), CD34 in 19 cases (82.6 %) and CD117 in 20 cases (87.0 %). 13 cases (56.5 %) expressed both myeloid and B lymphocyte antigens, in which cCD79a and cMPO were positively expressed, 7 cases (30.4 %) were found to express both myeloid and T lymphocyte antigens of cCD3 and cMPO 3 cases (13.04 %) were positive for both cCD3 and cCD79a. Conclusion cCD3,cCD79a, and cMPO were lineage specific antigen markers, which could be used for diagnosis and differential double phenotype leukemias. FCM is a useful and reliable method for diagnosis of acute leukemia, and guidance of treatment and prognosis of leukemia in clinical.