Objective To study the effect and mechanism of the neurological function recovery in rats with spinal cord injury (SCI) rats after the transplantation of neural stem cells which are directly differentiated from bone marrow mesenchymal stem cells (BMSC), and to investigate the suitable engraftment time.Methods The BMSC at 3rd passage were differentiated into neural stem cells (NSC), and immunofluorescence staining was used to identify the NSC. The oriented-induced cells were labeled with Brdu 3 days before they were transplanted, and they were slowly injected into the injured site of the SCI rats. The SCI rats were randomly divided into group Ⅰ (transplantation at first week postinjury), group Ⅱ (transplantation at 2nd week postinjury) and control group (the operation was the same as group Ⅰ, but the cell suspension was replaced by the equal volume of normal saline). The BBB scores after transplantation were recorded. The distribution and differentiation of transplanted cells were observed by using immunofluorescence staining with antibodies against Brdu combined with Nestion and Brdu combined with NF200. NF200 immunofluorescence staining was used to show the regeneration of nerve fibers. The pathological changes of the injured site were observed by HE staining.Results The nestin expression was positive after the BMSC were differentiated for 3 days, and if the induced spherical cells were cultured continuously, the different levels of NF200 and GFAP were found. BBB scores in group Ⅰ and group Ⅱ were significantly higher than in control group (P<0.05), especially in group Ⅰ. The immunofluorescence showed that a large number of Brdu and Nestin double-positive cells and some Brdu and NF200 double-positive cells filled the injured site and linked the two sides of the injured area in group Ⅰ and group Ⅱ, and the lesion area of the spinal cord was reduced as compared with control group (P<0.05). More importantly, further reduction in lesion area and improvement in neurological function were observed in group Ⅰ.Conclusion The BMSC can be differentiated into NSC. The transplantation of the NSC could effectively promote the nerve function recovery after SCI, and the effect of transplantation at first week postinjury was better than at 2nd week postinjury.

Objective To investigate the regulation of CCL22/CCR4 signaling on CD4 + CD25 + regulatory T cells (Tregs) and immune escape in hepatocellular carcinoma (HCC).Methods CCL22,interleukin-2 (IL-2),transforming growth factor-β (TGF-β),and interleukin-10 (IL-10) levels in tumor tissue of 30 HCC patients were determined by ELISA.Tumor infiltrating lymphocytes were isolated and assayed by flow cytometry to evaluate the change of CD4 + CD25 + Tregs in tumor tissue,and CCR4 in CD4 + CD25 +Tregs were detected.Results The CCL22 level in tumor tissue was obviously increased.The level of CCL22 in tumor tissue was (920.1-± 180.1)ng/L,which was significantly higher than that in non-tumor tissue [(227.2 ± 108.6) ng/L; P ＜ 0.05].The tumor infiltrating CD4 + CD25 + Tregs was obviously increased,reaching approximately to (13.3 ±4.0)％,and the CCR4 expression in CD4+ CD25 + Tregs increased to (8.8 ± 3.0) ％.Along with progression in clinical TNM staging,the levels of CD4 + CD25 + Tregs and CD4 + CD25 + CCR4 + Tregs in tumor tissue increased,and were correlated with the CCL22 level.IL-2 level in tumor tissue was decreased,but TGF-β and IL-10 levels were increased.HCC tissue can secrete a large amount of CCL22 that could recruit CD4 + CD25 + Tregs to tumor tissue by activating CCL22/CCR4 signaling.CD4 + CD25 + Tregs played an important role in the immune escape of HCC by releasing plenty of TGF-β and IL-10 and inhibiting IL-2 secretion.Conclusion This study validates CCL22/CCR4 as therapeutic targets in immunotherapy for HCC.

Objective To evaluate surgical resection combined with RFA and TACE for multiple hepatocellular carcinoma.Methods Between 2010 and 2013, 27 multiple hepatocellular carcinoma cases were treated with surgical resection combined with RFA and TACE.The clinical data and postoperative complications were observed.Results Left lateral lobectomy was performed in 4 patients, left hemihepatectomy was performed in 8 patients, right liver resection was performed in 3 patients, irregular right liver resection was performed in 12 patients.The operation time was (223 ± 77) min, The intraoperative bleeding was (435 ± 144) ml.There were not postoperative severe complications, such as hepatic hematoma, liver abscess, intraabdominal hemorrhage, liver failure.Unresected focus uderwent complete necrosis or liquefaction in the RFA regions as shown by CT scanning after 1 month in 24 patients.Postoperative, TACE was performed regularly in all the patients.Lipiodol deposition on the margin of RFA regions was found in 3 patients.After a year, new foci were found in 9 cases.Patients were followed-up from 8-39 months.The median survival time after operation was 26.3 months.The survival rates were 92％, 60％, 15％, respectively after 1, 2, 3 year.Conclusions For patients with multiple hepatocellular carcinoma, surgical resection combined with RFA and TACE was safe and effective.

BACKGROUND: Carbamylated erythropoietin (CEPO) cannot only remarkably promote the prognosis of cerebral infraction, but also improve the microcirculation. OBJECTIVE: To explore the underlying mechanism of CEPO promoting the microcirculation following cerebral infraction. METHODS: 150 Wistar rats were selected, and 120 rats were used for establishing the models of cerebral infarction, followed by allotted into four groups. The model rats were treated with 500, 1000 and 2000 u/kg CEPO as experimental groups, and those received no treatment as model group. The other 30 rats were as controls. Vascular endothelial cells were isolated and cultured in vitro, and the cell proliferation was detected by cell counting kit-8 assay. The expression levels of proliferation-related genes (Ki67 and p16) and vascular endothelial growth factor (VEGF) were detected using western blot assay. After selective silencing of VEGF through RNA interference, all above indicators were detected again. RESULTS AND CONCLUSION: Cell counting kit-8 assay results showed that the proliferation ability of vascular endothelial cells was increased with CEPO concentration increasing. Western blot assay results showed a significant upregulation of Ki67, p16 and VEGF. After shRNA-VEFG interference, these indicators had no positive correlation with the increased concentration of CEPO. Our findings indicate that CEPO can improve the proliferation of vascular endothelial cells in an animal model of cerebral infarction via upregulating the VEGF expression.

Objective To investigate the effect of oral exercise method combined with shaker exercise on dysphagia in patients with cerebral hemorrhage.Methods 112 patients with dysphagia caused by cerebral hemor-rhage were randomly divided into control group (28 cases,conventional treatment),oral exercise method group (28 cases,conventional treatment combined with oral exercise method),shaker exercise group (28 cases,conventional treatment combined with shaker exercise)and combination group (28 cases,conventional treatment combined with oral exercise method and shaker exercise).Four groups were assessed with video fluoroscopic swallowing study (VF-SS)before treatment and after treatment.Results (1)There were no differences on VFSS among four groups before treatment (P >0.05).After treatment,there were significant differences on VFSS among four groups(F =9.40,P <0.05).Combination group[(8.68 ±4.74)points]with the highest score,followed by shaker exercise group[(6.52 ± 3.12)points]and oral exercise method group[(6.43 ±2.84)points],control group[(3.96 ±2.02)points]with the lowest score.There were no differences on VFSS between before treatment and after treatment in control groups (F =0.945,P >0.05).In the remaining groups,the scores of VFSS after treatment were significant higher than that of before treatment (P <0.05).(2)The total effective rate in combination group was higher than that of the remaining groups(χ2 =37.76,P <0.01).Combination group (96.43%)combined with the highest total effective rate,followed by shaker exercise group (75.00%)and oral exercise method group (71.43%),control group (21.42%)combined with the lowest total effective rate.Conclusion The application of oral exercise method combined with shaker exercise on patients with dysphagia caused by cerebral hemorrhage could improve the swallowing function.

BACKGROUND:Pulmonary infection after kidney transplantation evolves rapidly. There is a high mortality rate in patients with server pulmonary infection. It has the important significance of early diagnosis and treatment of pulmonary infection, but some patients appear to have impaired kidney function because of the adjustment of immunosuppressants. OBJECTIVE:To explore the approaches to applying the immunosuppressants during the treatment of pulmonary infection after kidney transplantation. METHODS:The clinical data of 85 kidney transplantation patients who suffered from pulmonary infection were retrospectively analyzed. There were 43 cases in which the infection occurred within 1-6 months after kidney transplantation, 39 of which within 2-4 months; 7 cases of infection occurring within 6-12 months; 7 cases of infection within 12-24 months; 6 cases of infection within 24-36 months; 22 cases of infection occurring beyond 36 months. The immunosuppressant dose was adjusted based on a per-case basis. As a complement, the smal-dose hormone was used for anti-inflammation. Etiological treatments for resisting infections were also conducted accordingly. Ventilators were utilized for patients with respiratory failures. The body temperature of patients was monitored and controled. Appropriate nutrition support was also provided accordingly. There were 44 cases of decreasing or stopping the use of immunosuppressants during the early period of pulmonary infection; 19 cases of decreasing or stopping the use of immunosuppressants during the treatment of pulmonary infection;5 cases of stopping the use of immunosuppressants during the period of severe pneumonia; 15 cases of gradualy changing the dose of immunosuppressants during the early and progressive period of pneumonia; 2 cases of decreasing the use during the early period of pneumonia and stopping the use during the period of severe pneumonia. The duration of decreasing or stopping the use of immunosuppressants ranged from 3-51 days, with an average of 10.7 days. RESULTS AND CONCLUSION: Among the 85 patients, there were 81 cases cured and 4 cases of death. Among the four death cases, two cases died of acute respiratory failure and two cases died of multiple organ failure. Of the cured 81 cases, acute rejection occurred in 3 cases, while renal alograft dysfunction occurred in 6 cases. Decreasing or temporarily stopping the use of immunosuppressants during the treatment of pulmonary infection caused by the kidney transplantation increases the cure rate and decreases the mortality rate; while timely resuming the usage of immunosuppressants effectively protects the renal graft function, especialy for patients with renal graft dysfunction.

Objective To investigate the surgical procedures for chronic pancreatitis associated with pancreatic duct stones.Methods The clinical data of 17 cases of chronic pancreatitis with pancreatic duct stones surgically treated were analyzed retrospectively.Results Of the 17 cases,13 had pancreatic duct stones in the head of the pancreas.4 had pancreaticolithiasis in the body and tail of the pancreas,six had additional choledocholithiasis.Surgical treatments included Roux-en-Y anastomosis of the pancreatic duct and jejunum in 6 cases(Partington procedure),anastomosis of pancreatic duct and stomach in 4 cases (Warren procedure).subtotal resection of the head of the pancreas with duodenal preservation in 3 cases (Beger's procedure).removal of the tail of pancreas with Roux-en-Y anastomosis of the distal pancreatic end to the iejunum in 3 cases(Duval's procedure),removal of the tail of pancreas and spleen with a Roux-en-Y anastomosis of the distal pancreatic end to ieiunum in 1 case.All 17 patients were cured,with complete relief of intractable abdominal pain in 15 cases.blood glucose was under eontrol in two out of six diabetics.Two cases suffered from postoperative pancreatic fistula.one patient died of pancreatic cancer 11 months after operation.Conclusion For patients with chronic pancreatitis and pancreaticolithiasis.surgical treatment should be highly individualized.We suggest drainage procedures for patients with dilatation of the pancreatic duct.Patients with no dilatation of the pancreatic duct and those with suspected carcinoma can be treated by partial pancreatectomy and Roux-en-Y pancreaticojejunostomy.Meanwhile effort must be applied to preserve the exocnne and endocrine pancreatic function vital for the patient's quality of life.

OBJECTIVE:To observe the clinical efficacy and safety of atorvastatin combined with levamlodipine besylate in the treatment of elderly patients with hypertension combined with carotid plaque. METHODS:160 elderly patients with hyperten-sion combined with carotid plaque were randomly divided into control group(80 cases)and observation group(80 cases). Control group orally received Atorvastatin tablet 3 mg,qd+compound reserpine tablets 2 tablets,tid;observation group was received Atorv-astatin tablet(the same dosage and usage with control group)+Levamlodipine besylate tablet 2.5 mg,qd. They were treated for 8 months. Antihypertensive efficacy,blood pressure,and carotid intima-media thickness (IMT) before and after treatment,and the incidence of adverse reactions in 2 groups were observed and recorded. RESULTS:The antihypertensive effective rate in observa-tion group was significantly higher than control group,with statistical significance(P<0.05). Before treatment,there was no sig-nificant difference in blood pressure and IMT levels in 2 groups(P>0.05). After treatment,blood pressure and IMT levels in 2 groups were significantly lower than before,and observation group was lower than control group,with statistical significance(P<0.05). And there was no significant difference in the incidence of adverse reactions in 2 groups(P>0.05). CONCLUSIONS:Atorv-astatin combined with levamlodipine besylate shows good efficacy in the treatment of elderly patients with hypertension combined with carotid plaque,which can not only effectively control patients'blood pressure,but also improve atherosclerosis,reversing plaques and does not increase the incidence of adverse veactions.